Dear Editor, Lichen scrofulosorum (LS) is a rare tuberculid typically found in adolescents. It presents with a symptomless rash, commonly around the trunk. Some clinical variants, including lichenoid, psoriasiform and granuloma annulare-like variants, have been described previously. Here, we present the case of an elderly patient with an atypical clinical presentation of lichenoid-LS, which is clinically a mimic of lichen planus. To our knowledge, only one case of lichenoid-LS has been reported in Caucasians, and this is the first case reported in Asia. An 81-year-old man presented with a papular eruption on his face and trunk, which persisted for 2 months (Fig. 1a,b). He had a medical history of hypertension and teenage tuberculosis, with a family history of tuberculosis (four of his siblings had died between 10 and 11 years of age). Serological tests for hepatitis B, hepatitis C and syphilis were negative. Histopathology of skin biopsy specimens showed superficial dermal granulomas, without caseation necrosis, surrounding hair follicles (Fig. 1c,d). Ziehl–Neelsen staining showed no evidence of acid-fast bacteria, and tissue polymerase chain reaction analysis were negative for Mycobacterium tuberculosis. The tuberculin test was moderately positive, with an erythema measuring 15 mm 9 15 mm at 48 h. The QuantiFERON TB-Gold test (QIAGEN, Hilden, Germany) was also positive. Although a chest X ray and chest computed tomography demonstrated several 2–3-mm tiny pulmonary nodule shadows, the lung lesions were diagnosed as old pulmonary tuberculin, not pulmonary tuberculosis, by pulmonologists and radiologists. Collectively, lichenoid-LS was diagnosed and administration of isoniazid (300 mg/day), which is a standard treatment for latent tuberculosis, was initiated. The eruption almost disappeared within 2 weeks (Fig. 1e), and a chest X ray showed no deterioration in condition.