Cutaneous Horn — Appearance May be Deceptive

Abstract

Cutaneous horn (Cornu cutaneum), is a hard, projectile lesion developing from an unusual accumulation of keratin. The base of the horn may be flat, nodular or crateriform. Usually a cutaneous horn is several millimeters long. Histologically, there is a greatly thickened stratum corneum with scattered areas of parakeratosis. The lesion can originate from a variety of skin conditions ranging from benign to premalignant and malignant. Malignant lesions at the base of the horn usually are squamous cell carcinoma, although other carcinomas have been reported. When a Cutaneous horn has a larger base than its height, chances of malignancy are increased. Cutaneous horns are common in Caucasians but rare in Asians and Africans. A case of a facial cutaneous horn in an old lady is being presented here, which, despite having an ominous appearance was found to be benign. Conversely, a lesion with benign appearance may be harbouring malignancy implying that appearance of lesion may be deceptive. So all cutaneous horns irrespective of their appearance must be excised and sent for histopathological examination.

Keywords

• cornucutaneum
• malignancy