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Cutaneous horns: are these lesions as innocent as they seem to be?

DOI: 10.1186/1477-7819-2-18

Keywords: cornu cutaneum, squamous cell carcinoma, basal cell carcinoma, skin tumor, premalignant

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In this respective study, we describe our experience of eleven patients with cutaneous horn treated at our centre between January 2000 and January 2004. The clinical, pathological and treatment details were extracted from the case records. Data is presented as frequency distribution.There were 8 male and 3 female patients with a median age of 57 years. Most of the lesions were located on the ear, hand and scalp. Surgical resection was carried out in all the lesions. There were two cases of squamous cell carcinoma, and one case of basal cell carcinoma, other 8 cases were benign. None of the lesions recurred and no adjuvant treatment was given to any of the malignant lesions.Cutaneous horn is a clinical diagnosis that refers to a conical projection above the surface of the skin. The lesions typically occurs in sun exposed areas, particularly the face, ear, nose, forearms, and dorsum of hands. Even though our 60% of the cutaneous horns are benign possibility of skin cancer should always be kept in mind.Cutaneous horn (cornu cutaneum), is a projectile, conical, dense, hyperkeratotic nodule that resembles the horn of an animal [1]. The horn is composed of compacted keratin. A number of skin lesions can be found at the base of this keratin mound. Cutaneous horns most frequently occur in sites that are exposed to actinic radiation or burns, and hence, are typically found on upper parts of the face. Other locations include scalp, nose, eyelid, ear, lip, chest, neck and shoulder. Forearm, cartilaginous portion of the ear, leg and back of hands may also be involved [2]. Over 60% of the lesions are benign, however, malignant or premalignant lesions might be associated with it [3]. Keratosis, sebaceous molluscum, verruca, trichilemma, Bowen's disease, epidermoid carcinoma, malignant melanoma, and basal cell carcinoma have all been described in association with cutaneous horns [4]. For appropriate histopathological diagnosis, this lesion should undergo biopsy at the base of the


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