Tuberculosis is an endemic disease in India. A cutaneous post primary, paucibacillary manifestation of TB is lupus vulgaris. It affects approximately 0.1% of all cases of extra pulmonary Tuberculosis. Lesions are common in the head and neck. Lupus vulgaris is pleomorphic in presentation and warrants early recognition. We hereby report a rare case of lupus vulgaris. Case Report: A 47-year-old male patient presented with a painless gradually progressing lesion of one-year duration over the inner aspect of right arm. Six months after initial presentation new lesions appeared above the elbow on the left arm. On examination there were two subcutaneous nodules with overlying hyper-pigmented crusted plaque associated with minimal purulent discharge distributed symmetrically on medial aspect of both arms.

Keywords: Lupus Vulgaris, Bilaterally symmetrical