Genital cutaneous tuberculosis in a people living with human immunodeficiency virus/acquired immunodeficiency syndrome patient: A diagnostic conundrum

Primary cutaneous genital tuberculosis is a rare manifestation of tuberculosis facilitated by immune compromise due to concomitant human immunodeficiency virus (HIV) infection. We present a case of a 51-year-old male with HIV coinfection who developed noduloulcerative lesions on the penis, scrotum, and inguinal skin. Despite initial negative results from histopathology, serology, and conventional molecular tests, a tissue sample tested positive for Mycobacterium tuberculosis using a cartridge-based nucleic acid amplification test. The patient was initiated on standard antitubercular therapy, resulting in complete resolution of lesions after 6 months. This case highlights the importance of molecular diagnostics in diagnosing primary cutaneous genital tuberculosis, especially in immunocompromised individuals.