Chronic Recurrent Abscesses in A Child: Unmasking Scrofuloderma as A Form of Cutaneous Tuberculosis

Cutaneous tuberculosis, a rare extrapulmonary manifestation, constitutes a minor fraction of the overall TB disease burden, with scrofuloderma being the most common variant in paediatric populations. We present the case of a 7-year-old girl with a two-year history of recurrent abscesses on her chest and back that had recently enlarged. Previous incomplete treatment provided only temporary improvement. Clinical examination revealed classic signs of scrofuloderma, including multiple undermined ulcers with seropurulent discharge, sinuses, and puckered scars, accompanied by bilateral cervical lymphadenopathy in an otherwise systemically well child. Diagnostic workup revealed microcytic anaemia, an elevated erythrocyte sedimentation rate, and a strongly positive Mantoux test. Histopathological examination of a skin biopsy showed chronic inflammatory infiltrates with multinucleated giant cells, confirming the diagnosis. The patient was started on a standard four-drug anti- tubercular therapy regimen. This case underscores the characteristic clinical presentation of scrofuloderma in a child and highlights the critical importance of a high index of suspicion and the necessity of a complete, supervised course of ATT to achieve cure and prevent relapse, even in the absence of pulmonary involvement.