Cutaneous involvement is a relatively uncommon manifestation of tuberculosis. Cutaneous lesions account for less than 2 percent of all extrapulmonary manifestations. Due to the paucibacillary nature of the lesions, there is a potential for misdiagnosis, which could result in the chronicity of the skin infection. This article presents the case of a 34-year-old male butcher who presented with plaques exhibiting characteristics of verrucosa, acanthosis, and hyperkeratosis on both fingers for a period of 10 years. The diagnosis of Mycobacterium tuberculosis was confirmed by histopathologic examination. The patient was subsequently treated with a standard anti-tuberculosis regimen, which resulted in notable improvement in the skin lesions.