Tuberculosis with secondary vasculitis presenting as a nasal septal perforation

A 45 years old man with tuberculosis [TB] and secondary vasculitis presented with perforation of the nasal septum, involving skin and cranial nerves. Vasculitis is a recognized, tough rare complication of tuberculosis and has not been previously described in the literature as a cause of nasal septal perforation. It presents a diagnostic dilemma. The diagnostic challenges of this case are outlined, and the clinical implications are discussed