Scrofuloderma, a manifestation of cutaneous tuberculosis, is a less common but clinically significant form of mycobacterial infection. It typically arises from the contiguous spread of
Mycobacterium
tuberculosis
from an underlying infected lymph node or osseous structure to the adjacent skin. The condition manifests predominantly as chronic, granulomatous inflammation that leads to skin ulcers and abscesses. Despite its rarity, scrofuloderma presents substantial diagnostic challenges, primarily due to its nonspecific clinical presentation, which may mimic other dermatological conditions. This case report delineates the clinical journey of a patient with scrofuloderma who was attended to in a tertiary care setting. It emphasizes the diagnostic complexities encountered, underscored by a comprehensive discussion of the investigative modalities used to establish the diagnosis. This report elaborates on the therapeutic regimen taken, showcasing the effectiveness of a customized antituberculosis treatment plan.