Tuberculosis (TB) is commonly associated with the lungs, but what many people are not aware that tuberculosis can infect other organs, even the skin. Although pulmonary TB is so well known and feared, roughly 20% of cases of tuberculosis involve organs outside the lungs, a form called extrapulmonary TB. Of the infrequent instances of these rare forms, only 1.5% of these patients have tuberculosis verrucosa cutis, a skin-dwelling variety of TB causing painful warty plaques.A recent case report illustrates this unusual presentation, illustrating how TB can manifest in unconventional forms.In a strange case, as noted in The New England Journal of Medicine, a 59-year-old Chinese veterinarian grew a giant crusty wart on his hand. For one year, he experienced pain and discomfort before he eventually got himself to a doctor. His wart occupied the top of his right hand and part of his index finger, and it was a thick, yellow-brown crusted plaque.Although she did not have other typical symptoms of TB like coughing or fever, the physicians biopsied a tissue from the wart. When they tested it, they detected tuberculoid granulomas, groups of immune cells that develop when exposed to TB bacteria. These were verified by a positive interferon-γ release assay, an examination used for detecting TB infection.How Does TB Infect the Skin?Tuberculosis verrucosa cutis occurs when Mycobacterium tuberculosis enters the skin through an open wound or abrasion, usually in individuals who have been previously exposed to the bacteria. The condition is more commonly found in individuals with high occupational exposure to livestock or animals, such as veterinarians, butchers, and pathologists.The disease has been called "prosector's wart" at times, a historical name that was associated with the individuals who performed autopsies and regularly handled infected tissues. The affected regions are usually the hands, knees, and ankles, and the lesions develop into thick, wart-like plaques at the area of infection.Is Tuberculosis A Global Health Crisis?TB is still one of the most fatal infectious diseases globally. In the year 2022 alone, 1.3 million individuals lost their lives to tuberculosis. It is mostly transferred by air when an affected person coughs or sneezes, sending TB spores airborne.In this instance, however, the patient did not have TB in his lungs, making his affliction even more uncommon. Extrapulmonary cases of TB only amount to 20% of all TB infections, and of those, skin TB constitutes only 1.5%.Tuberculosis Treatment and RecoverySimilar to pulmonary TB, tuberculosis verrucosa cutis is also very treatable but must be treated for many months of antibiotics. The patient in the case study was put on antibiotics for six months, and his wart was already much better within two months.Although this is a rare case, it does highlight the necessity of identifying unusual TB infections, particularly in subjects with greater occupational risk. As early diagnosis and intervention are critical, it's imperative that healthcare professionals keep TB on their differential diagnoses when subjects present with anomalous skin lesions, especially in at-risk populations.This case is a reminder that TB is not simply a disease of the lungs. As we move forward fighting TB worldwide, it is important to be aware of its extrapulmonary manifestations—particularly tuberculosis verrucosa cutis. Early diagnosis and treatment can avoid complications and provide better outcomes for patients who suffer from this uncommon but serious illness.