Disseminated tuberculosis with atypical cutaneous manifestations in a child

Tuberculosis (TB) remains a major public health concern in endemic regions, with varied and sometimes unusual clinical manifestations in children. TB may present with cutaneous manifestations known as tuberculids, which are a type of hypersensitivity reaction to mycobacterial TB elsewhere in the body. Lichen scrofulosorum (LS) is one of the tuberculids. Here we present a case of a preschool-aged boy who presented with disseminated TB and cutaneous findings such as multiple soft tissue swellings over limbs along with LS. The child was treated with anti-tubercular therapy along with nutritional support. He showed resolution of skin and respiratory symptoms within weeks, with no recurrence or adverse effects on follow-up. Our case highlights a rare cutaneous manifestation of disseminated TB in children. In endemic regions, early recognition of these cutaneous signs in children with constitutional symptoms of TB is crucial for timely diagnosis and management of TB.