Chronic or persistent, nonhealing perianal ulcers could be due to an infection, inflammation, or a neoplasm. Perianal ulcer as the initial presentation of tuberculosis is rare. Tuberculosis cutis orificialis is a rare ulcerative form of cutaneous tuberculosis that affects the oral cavity, anal canal, or perianal region. A high index of suspicion for tuberculosis as the cause of persistent perianal ulcer is required for early diagnosis and treatment.
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