- Also called cornu cutaneum
- Descriptive clinical and histologic term for horn-like hyperkeratotic lesion, not a pathologic diagnosis
- Can be seen in association with a number of lesions, most commonly actinic keratosis, squamous cell carcinoma, verruca, seborrheic keratosis
- Other associations include basal cell carcinoma, trichilemmoma, trichilemmal horn, keratoacanthoma, epidermal nevus, epidermal cyst
- Many case reports of unusual lesions underlying cutaneous horns including angiokeratoma, psoriasis, discoid lupus, Kaposi sarcoma
- Sampling of the base of the lesion is necessary to determine the underlying etiology
- The underlying pathology is reported to be benign in approximately half of cases (BMJ Case Rep 2014 Apr 3;2014)
- Sebaceous tumors with cutaneous horns may be a marker for mismatch repair (J Cutan Pathol 2014;41:650)
- Usually solitary
- Predilection for the head and neck and hands of older persons
- Hard yellow to brown skin excrescence composed of compact keratin resembling a horn
- Can be straight or curved and can measure up to several centimeters in length
Firm to hard to the touch
- Usually epidermal type keratin (with granular layer)
- Occasionally has trichilemmal-like features (no granular layer but deep red granules) - termed trichilemmal horn
- Examination of the base of the lesion is needed to determine the underlying etiology
- Sometimes base contains epidermal hyperplasia without atypia
Actinic keratosis with cutaneous horn
Low power, c/o Hillary Elwood, M.D.
Verruca vulgaris, c/o Hillary Elwood, M.D.
End of Skin - Nonmelanocytic tumors > Benign (nonmelanotic) epidermal tumors or tumor-like lesions > Cutaneous horn
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