A rare case of verrucous cutaneous tuberculosis in a child with nephrotic syndrome

Background: Cutaneous tuberculosis is an uncommon form of tuberculosis that poses diagnostic challenges, especially in pediatric patients. Its manifestation on the skin presents diagnostic and treatment considerations, mainly when encountered in children. Case report: A 13-year-old boy with the main complaint of thick reddish spots appeared accompanied by scabs on the lower right arm which were painless and sometimes felt itchy which had been increasing since 1 month ago. There is a history of treatment in the patient, but the complaints have not decreased. The patient is undergoing routine treatment with a diagnosis in a pediatrician with steroid-resistant nephrotic syndrome. Dermatology finding: location on the right lower arm with efflorescence erythematous plaque, erosion, excoriation, yellowish crust, blackish red crust. Dermoscopy shows a yellowish to reddish background with a papillated surface, dirty white thick scales, yellowish-brown areas, and out-of-focus vascular structures. Histopathology: plasma cells, epithelioid histiocytes, and Langhans datia cells. The patient had received treatment for cutaneous tuberculosis in the first month and the lesions improved. Conclusion: Cases of cutaneous tuberculosis are a disease that often poses challenges in diagnosis because the presentation often resembles other skin conditions. With appropriate diagnosis and management, rare cases such as cutaneous tuberculosis in children can be treated effectively.