Cutaneos Horn

Cutaneous horn
Classification and external resources
File:SkinTumors-P5280062.JPG
Actinic keratosis with cutaneous horn
DiseasesDB	31351
eMedicine	article/1056568

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [3]

Overview

Cutaneous horns, also known by the Latin name cornu cutaneum, are unusual keratinous skin tumors with the appearance of horns, or sometimes of wood or coral. Formally, this is a clinical diagnosis for a "conical projection above the surface of the skin." They are usually small and localized, but can, in very rare cases be much larger. Although often benign, they can also be malignant or premalignant.

Etiology

The cause of cutaneous horns is still unknown, but it is believed that exposure to radiation can trigger the condition. This is evidenced by a higher rate of cases occurring on the face and hands, areas that are often exposed to sunlight. Other cases have reported cutaneous horns arising from burn scars. As with many other wart-like skin conditions, a link to the HPV virus family, especially the HPV-2 subtype has been suggested.

Prominent cases

• Zhang Ruifang, aged 101 (living in Linlou Village, Henan province, China), has grown a cutaneous horn on her forehead, resembling what those who have examined her and her family call "Devil's Horns." Notably, this growth has expanded to reach a total of 6 centimeters in length. Another is forming on the opposite side of her forehead.
• Huang Yuanfan, aged 84 (living in Ziyuan, China).
• Madame Dimanche, called Widow Sunday, a French woman living in Paris in the early 19th century, grew, in six years from the age of 76, a 24.9 cm (9.8") horn from her forehead before it was successfully removed by French surgeon Br. Joseph Souberbeille (1754–1846). A wax model of her head is on display at the Mütter Museum, The College of Physicians of Philadelphia, US.

Mortality/Morbidity

The lesion at the base of the keratin mound is benign in the majority of cases. Malignancy is present in up to 20% of cases, with squamous cell carcinoma being the most common type. The incidence of squamous cell carcinoma increases to 37% when the cutaneous horn is present on the penis. Tenderness at the base of the lesion is often a clue to the presence of a possible underlying squamous cell carcinoma .

Diagnosis

Physical Examination

Skin

Face

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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.

Extremities

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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.
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  Cutaneos horn. Adapted from Dermatology Atlas.

Treatments

As the horn is composed of keratin, the same material found in fingernails, the horn can usually be removed with a sterile razor.

However, the underlying condition will still need to be treated. Treatments vary, but they can include surgery, radiation therapy, and chemotherapy.

See also

• Wart
• Actinic keratosis
• Epidermodysplasia verruciformis
• List of cutaneous conditions

External links

• Matthew Moore (2007-11-12). "Tree man 'who grew roots' may be cured". London: Daily Telegraph. Retrieved 2007-11-14.
• "Images of cutaneous horns". DermAtlas. Retrieved 2007-11-14.
• DiClaudio, Dennis (2006) "The Hypochondriac's Pocket Guide to Horrible Diseases You Probably Already Have", Bloomsbury Publishing, ISBN 978-1-59691-061-4