A Verrucous Lesion on a Nose in HIV Seropositive Female: A Rare Case Report

Tuberculosis is a chronic granulomatous infectious disease caused by mycobacterium tuberculosis and mycobacterium bovis. Although commonly affecting lungs, almost all other organ systems may be involved. Cutaneous tuberculosis is one of the most challenging diseases to diagnose. It possesses a wide array of differential diagnosis and is difficult to confirm microbiologically, often leading to delayed diagnosis and treatment. Emergence of resistant strains and the HIV pandemic contribute to distribution of cutaneous tuberculosis worldwide. Clinical findings of cutaneous tuberculosis depend on source of infection and immune status of host. We report an HIV seropositive female presenting with a verrucous fungating growth over nose, which was diagnosed as tuberculosis cutis orificialis likely due to endogenous seeding from pulmonary disease. She was treated with extended anti-tubercular therapy (HRZE) fixed dose combination. The lesion responded remarkably to treatment and resolved completely within 18 months.