A curious ulcer on the pinna: rhinosporidiosis at an unusual place

Abstract

A curious ulcer on the pinna: rhinosporidiosis at an unusual place Editor, Rhinosporidiosis, a chronic mucocutaneous granulomatous infection caused by Rhinosporidium seeberi, was first described in Argentina over 100 years ago. 1 This disorder has been found to be endemic in India and Sri Lanka but has also been reported in the US, Iran, South America, and Africa. The most commonly involved sites are the nasal mucosa and nasopharynx (70-75% of cases), but the conjunctiva and lacrimal sac are occasionally involved (15%). 2 In the available literature, the skin, along with the urethra, genitalia, lips, palate, uvula, trachea, bronchus, ear, larynx, bone, and paranasal sinuses, has been sporadically involved in cases of rhinosporidiosis. 3,4 The clinical presentation is characterized by a painless sessile tumor with an irregular, friable, erythematous, muriform surface, often with white dots, hanging anteriorly into the nares or posteriorly into the pharynx. 5,6 Cutaneous lesions, albeit rare, have been reported in the form of cutaneous horn, verrucous plaques, polypoidal growths, subcutaneous nodules, furunculoid lesions, and ecthymatoid lesions. 6,7 We report a patient with cutaneous rhinosporidiosis presenting with an ulcerated growth over the right ear lobule, with nasal involvement.

Nondisseminated Rhinosporidiosis with Multisite Involvement in the Head and Neck

“…15 Similarly, the cutaneous lesion of rhinosporidiosis may resemble a low-grade neoplasm, verrucous plaques, cutaneous horns, a granulomatous growth, or a furunculoid lesion. 9,16,17 In the index case, the mucosal lesion in the larynx appeared similar to papillomatosis caused by human papilloma virus, and the cutaneous lesion of the cheek resembled a wart caused by the same virus. However, the diagnosis was never in doubt.…”

“…Apart from the nasal cavity and pharynx, rhinosporidiosis has affected various other sites in the head and neck including the parotid duct, conjunctiva, and pinna, which have mostly been involved in isolation. [7][8][9] Previously reported cases of multicentric head and neck rhinosporidiosis have mentioned the simultaneous involvement of skin across various anatomic sites such as muscle, external genitalia, urethra, and/or bone in the same patients. 10,11 These were the cases of disseminated rhinosporidiosis.…”