Cutaneous Tuberculosis

A 32-year-old woman from rural Maharashtra presents with a painless, indurated ulcer on her left shin for 8 months. The ulcer has a punched-out appearance with undermined edges and a granulating base. She reports a history of pulmonary tuberculosis treated 2 years ago. Examination reveals regional lymphadenopathy. A biopsy shows caseating granulomas with acid-fast bacilli on Ziehl-Neelsen staining. Which type of cutaneous tuberculosis is most likely?

A 28-year-old man from Delhi presents with a 6-month history of slowly progressive, painless nodules and plaques on his face and trunk. On examination, he has multiple soft, brownish nodules with an 'apple jelly' appearance on diascopy. He is HIV-negative with no history of TB contact. Histopathology reveals non-caseating granulomas with sparse acid-fast bacilli. What is the most likely diagnosis?

A 32-year-old woman from rural Maharashtra presents with a painless, indurated ulcer on her left forearm for 3 months. The ulcer has a punched-out appearance with undermined edges and minimal purulent discharge. She reports a history of tuberculosis in her father 2 years ago, which was treated successfully. On examination, the lesion measures 2 cm × 1.5 cm, and regional lymph nodes are enlarged and non-tender. A biopsy from the ulcer edge shows caseating granulomas with acid-fast bacilli on Ziehl-Neelsen stain. What is the most likely diagnosis?

A 28-year-old male farmer from Punjab presents with a slowly progressive, warty plaque on his right thumb that he sustained a minor cut while harvesting crops 6 months ago. The lesion is hyperkeratotic, violaceous, and has a well-demarcated border. There is no regional lymphadenopathy. Histopathology shows non-caseating granulomas with scanty acid-fast bacilli. Tuberculin skin test is strongly positive (18 mm induration). What is the most likely diagnosis?