A cutaneous horn is firm to hard to the touch. This image displays a cutaneous horn with a squamous cell carcinoma at the base. This image displays a cutaneous horn with a red, cancerous skin lesion at the base. This image displays a cutaneous horn arising from a squamous cell carcinoma.  Cutaneous horns typically occur on sun-exposed body parts, as displayed in this image.  This image displays a cutaneous horn on the neck. Not all cutaneous horns are pointed. Like all cutaneous horns, this lesion is extremely hard to the touch. <br />
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Cutaneous Horn  Information for adults

Picture of Cutaneous Horn: A cutaneous horn is firm to hard to the touch. Divider line
A cutaneous horn is firm to hard to the touch.
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Overview
A cutaneous horn, also known as cornu cutaneum, refers to a specific appearance of a skin lesion in which a cone-shaped protuberance arises on the skin caused by overgrowth of the most superficial layer of skin (epidermis). A cutaneous horn is not a particular lesion but is a reaction pattern of the skin. Approximately 40% of cutaneous horns represent precancerous lesions called actinic keratoses. Cutaneous horns may also overlie skin cancer. When overlying cancerous skin, squamous cell carcinoma is typically at the base of the cutaneous horn, but basal cell carcinoma is also possible.
Who's At Risk
Cutaneous horns most often occur in adults, usually elderly, fair-skinned individuals with a history of significant sun exposure.
Signs and Symptoms
A cutaneous horn most often occurs on sun-exposed areas and appears as a cone-shaped protuberance arising from a skin-colored to red/pink bump or flat lesion.
Self-Care Guidelines
None necessary.
When to Seek Medical Care
Seek medical evaluation if a cutaneous horn is noted. A biopsy may be needed to assess whether the lesion is benign, precancerous, or cancerous.
Treatments Your Physician May Prescribe
If the lesion is benign, no further treatment may be needed.

If the lesion is precancerous, the physician may:
  • Freeze the lesion with liquid nitrogen.
  • Use a topical chemotherapy agent, such as 5-Fluorouracil or a topical medicine that stimulates the immune system, imiquimod.
  • Scrape and burn (curettage and electrodesiccation) the lesion.
If the lesion is cancerous, the physician may:
  • Perform surgery.
  • Use a topical chemotherapy agent, such as 5-Fluorouracil or a topical medicine that stimulates the immune system, imiquimod.
  • Scrape and burn (curettage and electrodesiccation) the lesion.
  • Recommend radiation therapy.

References

Bolognia, Jean L., ed. Dermatology, pp.1715. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.721-723, 740. New York: McGraw-Hill, 2003.
Last Updated: 22 Dec 2008