Primary multi-drug resistant tuberculous gumma.

A 28-year old lady presented with three discrete gummatous lesions on the anterior abdominal wall, one at the site of a previous laparoscopic scar. Skin biopsy showed epitheloid cell granulomas and a pus culture and sensitivity (for AFB) performed, showed growth of M. tuberculosis. The culture-isolate was resistant to all the essential anti-TB drugs. The patient was put on second line anti-TB chemotherapy and the gummas resolved.