TB verrucosa cutis

This an indolent warty plaque that occurs as a direct inoculation of TB into the skin of individuals previously infected with m.tuberculosis or m.bovis. Re-infection TB can result from accidental exposure to tuberculous tissues in high risk groups such as physicians, pathologists and laboratory workers(anatomist`s wart, verruca necrogenica) 

Farmers ,butchers and veterinarians contract this form of re-infection TB from tuberculous cattle.

Lesions most commonly occur on the hands and in children the lower extremities.

Infection starts as an asymptomatic plaque of mistaken for verruca vulgaris. 

The lesion may show central involution with atrophic scar or form massive excrescences with fissures.the later may discharge pus.

Regional nodes are not affected unless secondary infection occurs.http://emedicine.medscape.com/article/1105317-overview