Unveiling a Dermatological Mystery: A Rare Case of Miliary Cutaneous Tuberculosis in an Adult Patient

Tuberculosis (TB) continues to pose a significant global health challenge, with Mycobacterium (M.) tuberculosis being the primary pathogen. Cutaneous tuberculosis, particularly in its miliary form, is a rare manifestation, accounting for a small proportion of extrapulmonary cases. We report the case of a 71-year-old male from Chihuahua, Mexico, with a history of smoking, diabetes, and hypertension, who presented with a disseminated polymorphic dermatosis. Histopathological examination revealed granulomas containing Langhans giant cells and acid-fast bacilli, with confirmation of M. tuberculosis through PCR and staining. The patient, in a compromised general condition, was diagnosed with miliary cutaneous tuberculosis and initiated on appropriate therapy. This case emphasizes the rarity of miliary cutaneous TB and highlights the importance of prompt and accurate diagnosis and management, particularly in immunocompromised individuals.