Tuberculosis (TB) is still a problem in the developed and underdeveloped countries, and cutaneous TB is a small part of extrapulmonary forms. Two most common forms of cutaneous TB are lupus vulgaris and scrofuloderma. Tuberculosis verrucosa cutis is a less common paucibacillary form of cutaneous TB caused by exogenous reinfection in sensitized people. Inoculation occurs through wounds or blisters and only rarely from the patient's own sputum. The diagnosis of cutaneous TB is often difficult because the clinical appearance of the lesion is often atypical. Acid fast staining test may be inconclusive in patients with high immune status. Mycobacterial culture is the gold standard for determining cutaneous TB; however, it is often time-consuming. Thus, PCR, which is faster and more sensitive compared to culture, is also often used in clinical practice. Therapeutic trials with antituberculosis therapy are justified if clinical suspicion is strong in which the diagnosis can be made based on the therapeutic response. Vora et al. stated that even the results of histopathological examination and PCR are often negative especially in paucibacillary cutaneous TB. Antituberculosis treatment trial is sometimes the only solution. Belgaumkar et al. stated that in cases of strong clinical suspicion but doubtful laboratory tests, dramatic response to antituberculosis therapy after 4 weeks can be considered a valuable diagnostic criteria. The report discusses a 46-year-old patient who was diagnosed as tuberculosis verrucosa cutis and given a trial of category 1 antituberculosis therapy, who subsequently showed significant clinical improvement after three weeks.