ABSTRACT
Introduction: Tuberculosis is a common infection caused by Mycobacterium tuberculosis in developing countries. Among the extrapulmonary forms of tuberculosis, cutaneous tuberculosis is rare, and even dermatologists are less familiar with its ungual manifestations. Case Presentation: We present an exuberant case of ungual tuberculosis in a patient with no personal or family history of immunosuppression, which is the first manifestation of the disseminated form of the disease. Conclusion: In our patient, the initial manifestation was related to the nail, probably originating from the progression of bone TB focus, which further progressed with respiratory symptoms and involvement of other organs. We believe this is the first case in which the ungual presentation allowed the diagnosis of disseminated tuberculosis.