Cutaneous horn in a sun-protected site harbouring unusual malignancy

Ashwath Narayan Ramji


Cutaneous horns are conical, circumscribed projections formed by desquamation and layering of keratin. Although they can appear on the skin anywhere on the body, they are most commonly seen on the sun-exposed surfaces, and are often associated with solar keratosis. Cutaneous horns are most often benign, however they are a potential site of malignancy and may harbor premalignant or malignant lesions, the most common being squamous cell carcinoma, the causal relationship being straightforward and both squamous cell carcinoma and cutaneous horns can be equated with the common epithelial maker keratin. Other histological types of malignancies are not usually noted in conjunction with cutaneous horns. Here we describe a patient with a cutaneous horn over the volar aspect of the right forearm, a sun-protected site, harboring basal cell carcinoma, an infrequent finding.


Cutaneous horns, Hidden malignancy, Basal cell carcinoma

Full Text:



Park H, Kim W, Kim H, Yeo H. Cutaneous Horn in Premalignant and Malignant Conditions. Arch Craniofac Surg. 2016;17(1):25-7.

Yu RC, Pryce DW, Macfarlane AW, Stewart TW. A histopathological study of 643 cutaneous horns. Br J Dermatol. 1991;124:449-52.

Bart RS, Andrade R, Kopf AW. Cutaneous horns. A clinical and histopathologic study. Acta Derm Venereol. 1968;48:507-15.

The Mütter Museum of the College of Physicians of Philadelphia. Available at: Accessed on 3 February 2019.

Phulari RG, Rathore R, Talegaon TP, Shah A. Cutaneous horn: A mask to underlying malignancy. J Oral Maxillofac Pathol. 2018;22(Suppl 1):S87-S90.

Michal M, Bisceglia M, Di Mattia A, Requena L, Fanburg-Smith JC, Mukensnabl P, et al. Gigantic cutaneous horns of the scalp: Lesions with a gross similarity to the horns of animals: A report of four cases. Am J Surg Pathol. 2002;26:789–94.

Kim YJ, Oh ST, Kang H, Park CJ, Park YM, Cho SH, et al. Clinicopathologic study of cutaneous horns. Korean J Dermatol. 2005;43:359–65.

Copcu E, Sivrioglu N, Culhaci N. Cutaneous horns: are these lesions as innocent as they seem to be? World J Surg Oncol. 2004;2:18.

Pyne J, Sapkota D, Wong JC. Cutaneous horns: clues to invasive squamous cell carcinoma being present in the horn base. Dermatol Pract Concept. 2013;3:3–7.

Schosser RH, Hodge SJ, Gaba CR, Owen LG. Cutaneous horns: a histopathologic study. South Med J. 1979;72:1129–31.

Quaedvlieg PJ, Tirsi E, Thissen MR, Krekels GA. Actinic keratosis: how to differentiate the good from the bad ones? Eur J Dermatol. 2006;16:335–9.

Souza LN, Martins CR, de Paula AM. Cutaneous horn occurring on the lip of a child. Int J Paediatr Dent. 2003;13:365-7.

Popadić M. Squamous cell carcinoma presenting as a giant cutaneous horn of the lower lip. Indian J Dermatol Venereol Leprol. 2014;80:74-6.

Cruz Guerra NA, Saenz Medna J, Ursua Sarmento I, Zamora Martinez T, Madrigal Montero R, Diego Pinto D, et al. Malignant recurrence of a penile cutaneous horn. Arch Esp Urol. 2005;58(1):61-3.

Mutaf M. A rare perioral lesion: Cutaneous horn of the lower lip. Eur J Plast Surg. 2007;29:339-41.

Sandbank M. basal cell carcinoma at the base of cutaneous horn (cornu cutaneum). Arch Dermatol. 1971;104(1):97–8.