A 52-year-old man presented with multiple asymptomatic lesions on the right ear, right upper extremity and back since last 2 years. The patient also had nasal obstruction and difficulty in breathing for 4 years due to a nasal polyp, that were excised several times, only to recur every time. On examination, there were multiple verrucous papular and nodular lesions on right pinna [Figure 1]. Verrucous lesions were present on back and right forearm. A skin-colored deep-seated tumorous mass was present on the right arm. Right anterior nares revealed a reddish polypoid growth. Biopsy showed upper and mid dermal nodular dense tuberculoid and suppurative granulomatous infiltrate with multiple sporangia in various stages of maturation. A few mature thick-walled endospore filled sporangia were seen. Overlying epidermis had moderate spongiotic psoriasiform change. Periodic acid-Schiff stained sections were positive for these organisms. Based on clinicopathological correlation, a final diagnosis of disseminated cutaneous rhinosporidiosis was rendered. Patient was started on oral dapsone, verrucous lesions were excised by radiofrequency ablation and surgical referral was done for the tumorous lesion.

Figure 1:: Multiple verrucous papular and nodular lesions on right pinna

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