<prompt> A 12 years old child presenting with painless neck swelling in supraclavicular region which started discharging after few days. The most probable diagnosis -ScrofulodermaActinomycosisBotromycosisFungal mycetoma  <response>: Ans. is a i.e., Scrofuloderma All the given options can cause the given clinical picture. But, most common presentation of scrofuloderma is neck swelling with discharge.Scrofuloderma Scrofuloderma is cutaneous tuberculosis due to direct extension of infection from an underlying tuberculosis present either in a lympnode, bone or a joint. Lesion has following characteristics: - Starts as bluish painless swelling, which breaks open to form Sinuses - Most common presentation is discharging sinuses. Sinuses discharge caseus or watery material. If ulcers occurs, they are linear or serpiginous, with undermined edges, and a floor of granulation tissue. Sites of predilection : -i Cervical most common, axillary inguinal lymph nodes.ii Legs from tubercular osteomyelitisiii Skin over sternoclavicular joint chestAbout other options Most common site of actinomycosis is angle of jaw and in question, there is no history of discharge of sulphur granules. Mycotic mycetoma and botromycosis are usually seen in foot and they also discharge granules made of microcolonies of organisms. 