Cutaneous horn: A mask to underlying malignancy

Abstract

Cutaneous horns (cornu cutaneum) are uncommon lesions consisting of keratotic material resembling that of an animal horn. It is a conical- or cylindrical-shaped excessive hyperkeratosis of variable size ranging from few millimeters to several centimeters with a variable in size and shape, such as cylindrical, conical, pointed, transversely or longitudinally corrugated, or curved like a ram's horn. The lesions typically occur in sun-exposed areas, particularly the face, ear, nose, forearms and dorsum of hands. Even though 60% of the cutaneous horns are benign in nature, the possibility of skin cancer should always be kept in mind. The clinical diagnosis includes various benign and malignant lesions at its base. Lesions associated with cutaneous horn are keratosis, sebaceous molluscum, verruca, trichilemmal, Bowen's disease, epidermoid carcinoma, malignant melanoma and basal cell carcinoma. Herewith, we report a case of cutaneous horn on the upper lip vermillion masking the underlying malignancy at its base.

Clinical and histopathological features of a lingual mucosal horn: First time described clinical case series

“…This type of injury can occur at any age, with non-smoking patients and in a good general health. The clinical form is similar to one observed for cutaneous horns [19][20][21] (Figure 4), especially those observed on the lips [20], presenting a firm conical growth but whose keratosis actinic growth can evolve towards a malignant transformation [21]. To our clinical experience, lingual mucosal horn has no potential malignity, nevertheless the histopathological analysis has to be performed to establish the diagnostic.…”

A Curious Case of Cutaneous Horn

“…They are relatively rare in Asian and African populations compared to Caucasians. This can be attributed to the protective action of melanin against ultraviolet radiation, which is believed to play a role in its etiology [4]. These cutaneous horns, although grossly similar, differ significantly from animal horns by the absence of an axial well-formed bone around which the hyperkeratotic epidermis and dermis are placed [6].…”

“…There appears to be no sex predilection, but the chances of presence of malignancy at the lesion's base are more in males compared to females [3]. Around 60% of these lesions are benign, whereas the rest of the lesions may harbor a variety of premalignant or malignant conditions at their base [4]. Owing to this, shaving the lesion off its base is discouraged and complete excision of the lesion along with the base followed by complete histopathological examination is to be carried out to identify the underlying pathology [5].…”

Cutaneous horn in a sun-protected site harbouring unusual malignancy

“…4 They are generally conical projections, but may vary in shape including cylindrical, transversely or longitudinally corrugated, or even curved like a ram's horn. 5 Although grossly similar, cutaneous horns in humans lack the axially positioned bone seen in animal horns. 6 Found on chronically sun-damaged skin, the face and scalp makeup the location of 30% of all cutaneous horns, and fair-skin and older age appear to be risk factors for their development.…”