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Before the advent of AIDS Mycobacterium avium complex (MAC) infections were rare, but currently they represent one of the most frequent causes of opportunistic infections in patients with AIDS (2). However, the primary skin infections by MAC, especially in immunocompetent subjects, are still exceptional today (1). The diagnosis of cutaneous TB is done by culture of biopsy fragments, as in our case, while fresh examination is usually negative; histology shows a granuloma that does not udergo caseous necrosis. The treatment of infections caused by MAC is difficult especially due to the occurrence of resistance to many antibiotics, but the situation has improved with the advent of new macrolides, such as clarithromycin. In the primary localized cutaneous infections of modest size the surgical treatment can be decisive.