(BMJ)—A 60-year-old man presented with multiple painless, enlarging cutaneous nodules for the past 6 months. Exam: nodular lesions on abdominal wall, arm, and neck. Labs: all WNL. Biopsy confirmed the dx. What is it?
Cutaneous rhinosporidiosis
Bowenoid papulosis
Tuberculosis
Squamous cell carcinoma
Leprosy
You are correct. Rhinosporidiosis is a chronic granulomatous disease caused by the aquatic protozoan Rhinosporidiosis seeberi. Biopsy showed multiple sporangia in different stages of development. The nasopharynx is the most commonly involved site, where it presents as pedunculated or sessile vascular polyps. Other less common sites of infection are the eyes, aerodigestive tract, and skin. The patient was asymptomatic 6 months after excision of all lesions followed by dapsone.

BMJ Case Rep 2015;2015:bcr2015209596
(BMJ)—A 57-yo man presented w/ pain and limited ROM over the third MCP joint after sneezing into the back of his left hand. Exam: deformity over third MCP joint; pain w/ flexion and extension of middle finger; and normal strength w/o sensory deficits. What is the diagnosis?
Ganglion cyst
MCP dislocation
Sagittal band rupture
Trigger finger
Extensor tendon rupture
You are correct. Sagittal band (SB) rupture is a rare injury, often seen in boxers. The sagittal bands stabilize the extensor tendons. Rupture causes extensor tendon dislocation and often occurs in the middle finger. Nontraumatic SB rupture can occur in rheumatoid arthritis. Tx comprises splinting in extension, but sometimes surgery is required. This pt was splinted, and 8 wks later, recovered w/o complications.
By vgreene, 14 April, 2015
By vgreene, 14 April, 2015
By vgreene, 14 April, 2015
By vgreene, 14 April, 2015