A 29-year-old female patient, referred from general medicine department was presented with asymptomatic purplish and black colored skin lesions over the face (around lips) and extremities since past 15 days. Patient was a known and treated case of pulmonary tuberculosis and had taken complete anti-tubercular treatment 2 years back. Three months back, before the development of skin lesions, patient came to our hospital with complains of continuous cough and heaviness in chest. 2 D echo was carried out, which showed blocking in left pulmonary artery due to thrombus with right ventricular enlargement. Patient was put-on oral Warfarin 2.5 mg once daily to dissolve the thrombus. At that time her sputum was negative for acid fast bacilli (AFB). Two and half months later the patient came back with worsening of her chest complaints and on investigation she was found to have reactivation of pulmonary tuberculosis (sputum positive for AFB). She also had the above mentioned skin lesions for which she was referred to skin out patient department (OPD). General examination revealed her poor general condition with multiple purple to black ecchymotic patches around mouth, upper, and lower extremities [Figures 1 and 2]. Skin over right knee revealed black eschar surrounded by ecchymotic patch and erythema [Figure 3]. She also had resolving grouped vesicular lesions involving right L3, 4 dermatome, and clinically, suggestive of Herpes zoster. Routine investigations were within normal limits. Prothrombin time international normalized ratio (PTINR) of patient was carried out, which initially was not recordable as it was very high. We advised enzyme linked immune sorbent assay (ELISA) for human immunodeficiency virus (HIV) antibodies taking in to consideration her reactivation of pulmonary tuberculosis, drug reaction, and herpes zoster. ELISA for HIV antibodies was reactive. Then the patient was admitted in medicine ward. Oral Warfarin was stopped and she was given two units of FFP on two alternate days. After giving one FFP, PTINR came down to 4 min, however, the patient died on the 4th day of admission.