eMedicine Specialties > Dermatology > Benign Neoplasms

Cutaneous Horn: Differential Diagnoses & Workup

Author: Fiona Larsen, MBChB, FRACP, Dermatologist/Dermatopathologist, Private Practice; Consultant Dermatologist, Waitemata District Healthboard
Coauthor(s): Carlos Ricotti, MD, Fellow, Department of Dermatology, Division of Dermatopathology, University of Texas Southwestern School of Medicine; Clay J Cockerell, MD, Director, Clinical Professor, Department of Dermatology, Division of Dermatopathology, University of Texas Southwestern Medical Center
Contributor Information and Disclosures

Updated: Jun 18, 2009

Differential Diagnoses

Warts, Nongenital

Other Problems to Be Considered

Perforating pilomatricoma19

Workup

Laboratory Studies

Diagnosis is confirmed with a skin biopsy. An adequate specimen usually can be obtained with a simple shave biopsy. The specimen must be of sufficient depth to ensure that the base of the epithelium is obtained for histologic examination.

Histologic Findings

The horn is composed of compact hyperkeratosis, which may be either orthokeratotic or parakeratotic in nature. Associated acanthosis is a common finding. The base will display features of the pathologic process responsible for the underlying lesion.20

More on Cutaneous Horn

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Differential Diagnoses & Workup: Cutaneous Horn
Treatment & Medication: Cutaneous Horn
Follow-up: Cutaneous Horn
Multimedia: Cutaneous Horn
References
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References

  1. Srebrnik A, Wolf R, Krakowski A, Baratz M. Cutaneous horn arising in cutaneous leishmaniasis. Arch Dermatol. Feb 1987;123(2):168-9. [Medline].

  2. Dabski K, Stoll HL. Cutaneous horn arising in chronic discoid lupus erythematosus. Arch Dermatol. Jul 1985;121(7):837-8. [Medline].

  3. Goette DK. Cutaneous horn overlying granular cell tumor. Int J Dermatol. Nov 1987;26(9):598-9. [Medline].

  4. Findlay RF, Lapins NA. Pyogenic granuloma simulating a cutaneous horn. Cutis. Jun 1983;31(6):610-2. [Medline].

  5. Brownstein MH, Shapiro EE. Trichilemmomal horn: cutaneous horn overlying trichilemmoma. Clin Exp Dermatol. Mar 1979;4(1):59-63. [Medline].

  6. Gould JW, Brodell RT. Giant cutaneous horn associated with verruca vulgaris. Cutis. 1999;64:111-2. [Medline].

  7. Sandbank M. Basal cell carcinoma at the base of cutaneous horn (cornu cutaneum). Arch Dermatol. Jul 1971;104(1):97-8. [Medline].

  8. Cristobal MC, Urbina F, Espinoza A. Cutaneous horn malignant melanoma. Dermatol Surg. Aug 2007;33(8):997-9. [Medline].

  9. Dabski K, Stoll HL Jr. Paget's disease of the breast presenting as a cutaneous horn. J Surg Oncol. Aug 1985;29(4):237-9. [Medline].

  10. Peterson JL, McMarlin SL. Metastatic renal-cell carcinoma presenting as a cutaneous horn. J Dermatol Surg Oncol. Oct 1983;9(10):815-8. [Medline].

  11. Brauninger GE, Hood CI, Worthen DM. Sebaceous carcinoma of lid margin masquerading as cutaneous horn. Arch Ophthalmol. Nov 1973;90(5):380-1. [Medline].

  12. Kitagawa H, Mizuno M, Nakamura Y, Kurokawa I, Mizutani H. Cutaneous horn can be a clinical manifestation of underlying sebaceous carcinoma. Br J Dermatol. January 2007;156(1):180-2. [Medline].

  13. Korkut T, Tan NB, Oztan Y. Giant cutaneous horn: a patient report. Ann Plast Surg. Dec 1997;39(6):654-5. [Medline].

  14. Solivan GA, Smith KJ, James WD. Cutaneous horn of the penis: its association with squamous cell carcinoma and HPV-16 infection. J Am Acad Dermatol. Nov 1990;23(5 Pt 2):969-72. [Medline].

  15. Vera-Donoso CD, Lujan S, Gomez L, Ruiz JL, Jimenez Cruz JF. Cutaneous horn in glans penis: a new clinical case. Scand J Urol Nephrol. 2009;43(1):92-3. [Medline].

  16. Nthumba PM. Giant cutaneous horn in an African woman: a case report. J Med Case Reports. December 2007;1:170. [Medline].

  17. Mencia-Gutierrez E, Gutierrez-Diaz E, Redondo-Marcos I, Ricoy JR, Garcia-Torre JP. Cutaneous horns of the eyelid: a clinicopathological study of 48 cases. J Cutan Pathol. Sep 2004;31(8):539-43. [Medline].

  18. Vano-Galvan S, Marques A, Munoz-Zato E, Jaen P. A facial cutaneous horn. Cleve Clin J Med. Feb 2009;76(2):92-5. [Medline].

  19. Uchiyama N, Shindo Y, Saida T. Perforating pilomatricoma. J Cutan Pathol. Aug 1986;13(4):312-8. [Medline].

  20. Yu RC, Pryce DW, Macfarlane AW, Stewart TW. A histopathological study of 643 cutaneous horns. Br J Dermatol. May 1991;124(5):449-52. [Medline].

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Further Reading

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Keywords

cutaneous horn, cornu cutaneum, angiokeratoma, angioma, benign lichenoid keratosis, cutaneous leishmaniasis, dermatofibroma, discoid lupus, infundibular cyst, epidermal nevus, epidermolytic acanthoma, fibroma, granular cell tumor, inverted follicular keratosis, keratotic pseudoepitheliomatous balanitis, micaceous pseudoepitheliomatous balanitis, organoid nevus, prurigo nodularis, pyogenic granuloma, sebaceous adenoma, seborrheic keratosis, trichilemmoma, verruca vulgaris, adenoacanthoma, actinic keratosis, arsenical keratosis, basal cell carcinoma, Bowen disease, Kaposi sarcoma, keratoacanthoma, malignant melanoma, Paget disease, renal cell carcinoma, sebaceous carcinoma, solar keratosis, squamous cell carcinoma

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Contributor Information and Disclosures

Author

Fiona Larsen, MBChB, FRACP, Dermatologist/Dermatopathologist, Private Practice; Consultant Dermatologist, Waitemata District Healthboard
Disclosure: Nothing to disclose.

Coauthor(s)

Carlos Ricotti, MD, Fellow, Department of Dermatology, Division of Dermatopathology, University of Texas Southwestern School of Medicine
Carlos Ricotti, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, and International Society of Dermatopathology
Disclosure: Nothing to disclose.

Clay J Cockerell, MD, Director, Clinical Professor, Department of Dermatology, Division of Dermatopathology, University of Texas Southwestern Medical Center
Clay J Cockerell, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, International Academy of Pathology, International AIDS Society, International Society for Dermatologic Surgery, North American Clinical Dermatologic Society, Society for Investigative Dermatology, and Southern Medical Association
Disclosure: Nothing to disclose.

Medical Editor

R Stan Taylor, MD, Professor of Dermatology, University of Texas Southwestern Medical School; Director of Skin Surgery and Oncology Clinic, Department of Dermatology, University of Texas Southwestern Medical Center
R Stan Taylor, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, Christian Medical & Dental Society, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Edward F Chan, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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