A 41-year-old man presented to our clinic with a 4-year history of itching and mild tenderness in the perianal area. He was previously diagnosed with tinea corporis at a dermatology clinic and had received topical antifungal treatment for four years. On presentation, he denied experiencing fever, chills, non-productive and productive cough, weight loss, and night sweats. Physical examination revealed elevated coalescent erythematous scaling plaques (8 cm×8 cm) on the right buttock (Figure 1A). Laboratory examination revealed human immunodeficiency virus negativity. Biopsy of the lesion revealed pseudoepitheliomatous hyperplasia with granulomatous inflammation in the superficial dermis (Figure 1B); periodic acid-Schiff and acid-fast bacilli stains were negative. Chest radiography revealed focal haziness in the right upper lobe, and chest computed tomography showed nodules and peribronchial infiltration in the right upper lobe (Figure 2). M. tuberculosis was isolated from the cutaneous tissue and sputum; it was not resistant to anti-tuberculosis agents. Thus, treatment with anti-tuberculosis agents such as isoniazid, rifampicin, ethambutol, and pyrazinamide was initiated for 2 months, which was followed by isoniazid, and rifampicin therapy for 4 months. Subsequently, the lesion completely resolved without recurrence.