A 48-year-old male patient presented to Skin and VD outpatient with multiple granulomatous growths of different sizes all over the body, including numerous subcutaneous swellings mimicking lipomas of 2 years duration. Two and half years back he was operated for a polypoidal growth of left nostril with subsequent recurrence. Fine needle aspiration cytology and histopathology of the cutaneous lesion confirmed the diagnosis as rhinosporidiosis. We report this rare case of disseminated cutaneous rhinosporidiosis.

Botryomycosis is a rare chronic bacterial granulomatous disease that usually involves skin and rarely viscera. Main etiological agent is Staphylococcus aureus and less commonly Pseudomonas spp., Escherichia coli, Proteus spp., Streptococcus spp. We here report a case of 32-year-old male with polymicrobial botryomycosis on forehead and on frontal scalp. Culture from lesions revealed growth of S. aureus initially. Partial resolution was achieved with cefadroxyl and clavulanic acid, rifampicin, and linezolid. Subsequent repeat culture revealed E. coli sensitive to netilmycin. Slow and steady resolution was achieved with surgical debridement and combination therapy of injectable netilmycin and oral sufomethoxazole and trimethoprim for a prolonged period.

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We report two cases of epitheloid hemangioma presented with multiple nodular lesions over head and neck region. One of them gave history of bleeding on minor trauma. Pyogenic granuloma was considered as a differential diagnosis from the morphological appearance and history of bleeding. Nodular leprosy, sarcoidosis, and secondary syphilis were also considered. Histopathological examination of both was typical of epitheloid hemangioma, an entity commonly overlooked clinically due to its rarity.