Abstract: A 74-year-old male patient presented with multiple nodules, cysts, necrosis, crusting, and scars with pain in the anterior neck and bilateral axillae for 2 years. He was considered a skin infection in a local hospital. He received anti-inflammatory, pain-relieving, and traditional Chinese medicine treatments, but the efficacy was unsatisfactory, so he was referred to our hospital for further diagnosis and treatment. Pathological examination revealed multinucleated giant cells; T-SPOT test was positive; MetaCAP high-throughput sequencing of pathogenic microbial nucleic acids detected Mycobacterium tuberculosis complex. The diagnosis was scrofuloderma. After oral administration of a triple-drug regimen consisting of isoniazid, rifampicin, and ethambutol, the skin lesions subsided significantly.

Key words: scrofuloderma