A 35-year-old female presented to our clinic with slightly tender lumps and hyperpigmented depressed scars on both lower legs. The first lesions appeared ten years ago as erythematous macules and nodules. Some lesions became ulcerated and healed as hard hyperpigmented atrophic scars. Four months prior to consultation, new lumps appeared on both legs. There was no history of injuries, contact with TB patients, or symptoms of pulmonary or extrapulmonary TB. The patient was overweight while other aspects of general examination were within normal limit. Deep atrophy of the skin resulted in asymmetrical lower leg shape without movement disability (Figure 1). Varicose veins were observed on popliteal fossa (Figure 1). Dermatological examination revealed erythematous-violaceous, deep-seated nodules and macules, as well as hyperpigmented plaques on one-third distal portion of both lower legs. Some skin lesions showed superficial ulcers on deep skin atrophy covered with crusts and scales (Figure 1). Histopathological examination showed lobular panniculitis (Figure 2A) without vasculitis and granulomatous inflammation (Figure 2B) which consisted of caseous necrosis (red circle), epithelioid cells, and multinucleated giant cells (red arrow). There were no thickened collagen bundles, mucin deposition, and hyalinization. Direct immunofluorescence on skin lesion reveals no deposit of immunoglobulin or complement. The results of chest radiograph and sputum smear did not support the diagnosis of pulmonary TB. Tuberculin skin test (TST) was positive with a 20-mm induration after 48 hours. Polymerase chain reaction (PCR) examination using GeneXpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) on specimen obtained from skin biopsy was positive for deoxyribonucleic acid (DNA) of MTB. Nuclear 99mTc-ethambutol scintigraphy was positive for tuberculosis infection in the one-third distal portion of the left lower leg (Figure 3). Based on those results, the diagnosis of EIB was established. The patient was therefore treated with fixed-dose combination (FDC) of anti-tuberculosis drugs. After 6 months of treatment, the nodules regressed and healed, and no new skin lesions occurred (Figure 4).