Penile papulonecrotic tuberculid in a 30-year-old male: A rare manifestation of cutaneous tuberculosis

Papulonecrotic tuberculid (PNT) is a rare cutaneous manifestation of tuberculosis (TB), believed to result from a hypersensitivity reaction to Mycobacterium tuberculosis antigens in individuals with a robust immune response. While it typically presents as necrotizing papules on the extremities or trunk, genital involvement, particularly of the penis, is exceedingly rare and often misdiagnosed. We report a case of a 30-year-old immunocompetent male with asymptomatic necrotic papules on the glans penis. A strongly positive Mantoux test (19 mm induration) and histopathological features consistent with PNT, along with a complete therapeutic response to anti-tubercular therapy (ATT), confirmed the diagnosis. This case underscores the importance of considering tuberculids in the differential diagnosis of penile lesions, especially in TB-endemic regions.