Disseminated cutaneous rhinosporidiosis

Rhinosporidiosis   is   a   chronic   granulomatous   disease   of   the mucocutaneous tissue, which clinically presents as polypoidal growths. Cutaneous lesions  are  infrequent  and  are  generally  associated  with  mucosal  lesions.  We present a case of disseminated cutaneous rhinosporidiosis in a 61-year-old male, a farmer  from  rural  southern  India  who  presented  with  generalised  nodulo-ulcerative lesions all over the body but mainly on the face, thorax and extremities. The patient had a history of a surgical excision of a nasal polyp. No mucosal lesions were  detected  on  anterior  and  posterior  rhinoscopy.  Fine  needle  aspiration cytology  from  the  nodules  stained  by  Papanicolaou  and  Gomori  methenamine silver  showed  the  presence  of  endospores  suggestive  of  rhinosporidiosis. The patient  was  treated  with  dapsone  100  mg  daily  for  six  months. At  a  six-month follow-up  the  cutaneous  lesions  were  unchanged. The  majority  of  the  cases  of cutaneous rhinosporidiosis described in the literature have a primary lesion inside the nose. Here we report a rare case of disseminated cutaneous rhinosporidiosis without mucosal involvement.