Disseminated cutaneous rhinosporidiosis: varied morphological appearances on the skin

Rhinosporidiosis is a chronic granulomatous disorder caused by Rhinosporidium seeberi . It frequently involves the nasopharynx and occasionally affects the skin. We report a case of 45-year-old man who had disseminated cutaneous rhinosporidiosis with cutaneous pseudohorn, its base arising from rhinosporidiosis. The case presented with multiple reddish lesions over the nose of six years duration. In the past year, he developed skin lesions over the left arm, forearm, back, and chest. On examination, polymorphic lesions of rhinosporidiosis in form of verrucous plaque, unulcerated tumor, granulomatous growth, and furunculoid lesions were observed. Interestingly, there was a cutaneous horn over the chest which on histopathological examination showed hyperplastic epithelium with numerous globular cysts of varying shape, representing sporangia in different stages of development and transelimination. Computerized tomography scan of the chest showed bilateral opacities suggestive of lung involvement. On the basis of these clinical and histopathological findings, a diagnosis of nasal rhinosporidiosis with cutaneous and systemic dissemination was made.