Introduction: Because of the resurgence of tuberculosis in the world, cutaneous tuberculosis remains a clinical and diagnostic problem. Lupus vulgaris is the most common type of cutaneous tuberculosis. Case Report: Herein we present a 35-year-old male with multiple skin lesions in the face and neck since several years ago. Unfortunately due to unscientific manipulation, clinical appearance of the lesions had changed. Thus, the patient underwent laser therapy with the clinical diagnosis of psoriasis or hemangioma. However, because of unsatisfactory response to treatment, the lesions underwent biopsy. Histologic sections, revealed well-formed granuloma accompanied by langhans’ type giant cells and significant lymphocytic infiltration at periphery. Considering the site of lesions, histologic appearance and positive tuberculin test, the diagnosis of lupus vulgaris was confirmed. Conclusion: The above-mentioned patient’s history reemphasizes that clinical appearance of a skin disease by itself does not suffice for diagnosis and therapy. Therefore, biopsy and histopathologic investigation are recommended for atypical lesions.
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