Abstract
Lupus vulgaris (LV), a common form of cutaneous tuberculosis (TB), is rarely encountered in children. The disease follows a chronic course and often mimics other dermatological conditions, posing a diagnostic challenge and leading to inappropriate management. We report a rare case of a three-year-old boy who presented with a chronic ulcerated facial lesion persisting for the past two years. Skin biopsy revealed granulomatous inflammation with Langhans giant cells. A comprehensive TB workup was performed along with an evaluation to exclude other differential diagnoses. Despite negative acid-fast bacilli (AFB) staining, the diagnosis was established based on clinical features and histopathological findings. The patient responded well to standard antituberculosis therapy. On follow-up, the lesion had largely resolved without complications. This case highlights the importance of early recognition and treatment of LV, especially in TB-endemic regions, to prevent permanent disfigurement.