A pre-auricular solitary tuberculous ulcer

Cutaneous tuberculosis occurring sporadically in atypical sites could cause a diagnostic dilemma and lead to delay in treatment. We describe a 6-year old child who presented with a chronic, non-healing ulcer over the right pre-auricular region. There was no improvement with treatment from various practitioners over 2 months. On evaluation, we found that he had a negative smear for acid fast bacilli and a normal chest radiograph, but the Mantoux test done on him was strongly positive. His response to 3-drug anti-tubercular treatment further confirmed the diagnosis. The awareness of uncommon clinical forms of tuberculosis over atypical sites could help child health care providers diagnose the condition early.