Cornu Cutaneum Research Articles

Cornu cutaneum in the maxillofacial region – A case report

Cornu cutaneum are horn-like skin protrusions comprised of dense keratin. They differ from animal horns in a sense that cornu cutaneum do not have a central bone. The lesions may develop in any part of the body, with 30% of the lesions occurring in the head and neck region. Although they are considered benign lesions, they are characteristically associated with pre-malignant or malignant lesions such as squamous cell carcinoma, actinic keratosis, keratoacanthoma, basal cell carcinoma and Kaposi sarcoma. The aim of this clinical case report is to review a case of cornu cutaneum of the face associated with a papillary squamous cell carcinoma in a 72-year-old female We reviewed a case of cornu cutaneum of the left pre auricular area of the face with a 5-year history. The lesion was asymptomatic, measured 6cm in length and was resected under general anaesthetic with wide margins. The histopathological examination showed papillary a squamous cell carcinoma at the base of the lesion. As the lesions are benign and the nearest margin was 9mm, no further adjunct therapy was instituted. Although considered a benign lesion, cornu cutaneum is invariably associated with malignant lesions such as squamous cell carcinoma. Similarly, our case was associated with a papillary squamous cell carcinoma at the base of the lesion. As per current standards, the lesion was resected with wide margins

A Squamous Cell Carcinoma Presenting as a Giant Cutaneous Horn over the Lower Lip in a Patient with Chronic Disseminated Lupus Erythematosus.

A Squamous Cell Carcinoma Presenting as a Giant Cutaneous Horn over the Lower Lip in a Patient with Chronic Disseminated Lupus Erythematosus.

Cutaneous Horn Revisited: A Woman With a Verruca Vulgaris-Associated Cornu Cutaneum

A cutaneous horn, sometimes referred to as cornu cutaneum, is a projection arising on the skin due to an overgrowth of the epidermal stratum corneum. This lesion is a clinical presentation of an underlying skin tumor. A woman with a verruca vulgaris-associated cutaneous horn is described. Cutaneous horns are often solitary and appear most commonly on the face, ears, and the dorsum of the hands of older patients. The most frequent tumors associated with cutaneous horns include actinic keratoses and seborrheic keratoses; however, cutaneous horns have also been observed overlying other benign and malignant tumors. In conclusion, a cutaneous horn is a common clinical feature; however, the diagnosis of the underlying skin lesion requires a biopsy that permits adequate microscopic evaluation of the associated tumor.

To the doctrine of keratodermia palmaris et plantaris symmetrica (Besnier)

Skin diseases characterized by anomalies of keratinization in the sense of hypertrophy of the stratum corneum were named by Lebert in 1864 keratosis (keratosis circumscripta et keratosis diffusa). Hebra in his textbook on skin diseases distinguishes between the following two forms: keratosis without simultaneous participation in the process of skin papillae (callositas, clavus, cornu cutaneum) and keratosis, accompanied by more or less pronounced resolution of the papillary layer (verruca, ichthyosis).

Cornu cutaneum – Past and present

Cutaneous horn has been a source of controversy throughout the history. It evoked interest nearly half a millennium before and continues to do so. Cornu cutaneum has been found to be associated with several pre-malignant and malignant skin conditions. The pre-malignant conditions commonly include actinic keratoses and Bowen’s disease. Uncommonly, it is due to the presence of an underlying squamous cell carcinoma. Thus, an effort is needed to determine the pathology present at the base of the horn for proper management of the disease. Wide excision biopsy is a common denominator in the therapy of this peculiar disorder.

A giant cutaneous horn of oral commissure: a case report

Cutaneous horn is a conical, circumscribed, dense hyperkeratotic protrusion from skin with epithelial cornification. It is also known by the Latin name ‘Cornu cutaneum’. This rare medical entity resembles animal horn but histological disparity is present between both. They are more commonly present in sun exposed sites or areas that are prone for actinic radiation, burns and hence frequently seen in forearm and upper part of face. Only few cases have been reported with cutaneous horns in unusual sites. Cutaneous horns occurring in oral cavity or perioral regions are extremely rare. The significance of knowing about this dead keratinous cutaneous horn is that it may occur as a part of or in association with a wide range of underlying pathologies, either malignant, premalignant or benign. Majority are due to benign pathologies. We report an unusual presentation of cutaneous horn in left oral commissure of a 45-year-old gentleman which is an extremely rare perioral location for such an ailment.

Extrém méretű cornu cutaneum az alsó ajkon

A pácienst évtizedek óta az alsó ajakpíron növekvő, az észleléskor 15 cm-es cornu cutaneummal és fekélyes nyálkahártyaelváltozással irányították osztályunkra. CT és PET-CT vizsgálatot követően lineáris excisiót és tumor exstirpatiótvégeztünk. A szövettani vizsgálat malignitást igazolt. Azóta a beteget az onko-team döntése alapján szoros kontroll alatttartjuk, jelenleg is tünet- és panaszmentes.

Cutaneous horn arising from the scrotum

A cutaneous horn, cornu cutaneum, is a hard, conical projection composed of compacted keratin that resembles the horns of animals. They commonly occur on sun-exposed areas, including the head, ears, forearms and hands. Cutaneous horns are extremely rare. Although most are benign in nature, a significant portion may harbour a malignant or pre-malignant lesion, and histopathological analysis of the base of the lesion is imperative to categorise it as one of benign aetiology or one of a more sinister pathology. We present a case of a 46-year-old male who presented with a 2-month history of a painless, firm, rapidly growing conical projection arising from his scrotum. Clinically, a non-tender curved, yellow-brown, horn-like projection was observed arising from the median raphe of his scrotum. With informed consent, a full-thickness excision, with adequate excision of the base of the horn, was performed under local anaesthesia. Macroscopically, the exophytic keratinous lesion was 7.5 cm long and 1.8 cm wide, with the length of the horn far outweighing the width at its base. Histopathological analysis confirmed the presence of a cutaneous horn arising from a condyloma acuminatum as evidenced by a verruciform architecture with tiers of parakeratosis in association with hypergranulosis and koilocytes. No dysplastic or malignant changes were present in the epithelium. According to our knowledge, this is the first case in the English literature of a cutaneous horn arising from the scrotal skin.

A GIANT POST AURICULAR CUTANEOUS HORN: A RARE CASE REPORT

A cutaneous (cornu cutaneum) horn is a rare lesion which usually appears in sun-exposed areas and is very uncommon. It is a conical projection of hyperkeratotic epidermis and can be from a few millimeters to several centimeters in length. Here, we present the case of a large “horn” of long duration, arising in the right postauricular region in a 32-years-old male. The lesion was carefully examined, evaluated, complete excision was done with adequate margins and the defect was closed with primary closure after mobilizing the skin flaps adequately. Histopathologic examination showed the skin with underlying epidermis and extensive hyperkeratosis with no malignant cells seen at the base of the horn. It is important to mention that horn itself, is not the most important issue, but rather the underlying condition, which may be malignant also, needs to be ruled out and addressed.

Cornu cutaneum of Pinna

Introduction
 Cornu cutaneum is a nodule of dense keratin, resembling the horn of animals, an uncommon clinical condition predominantly seen in elderly men, and even rare to be seen on the pinna.
 
 Case Report
 A 70 year old man, presented with a horn like swelling on the left pinna for 2 years. The lesion was excised and histopathological examination did not show any underlying or associated conditions. 
 Discussion
 The cause of worry here is not the disfigurement, but the probability of underlying premalignant or malignant condition. Exposure to sunlight is considered as the etiology. Ours being a tropical country where exposure to sunlight could not be avoided, a high clinical vigil and early intervention is recommended to reduce the mortality and morbidity from the spectrum of diseases resembling this condition.

Cutaneous horn (cornu cutaneum) in a Pakistani goat

Cutaneous horn (cornu cutaneum) is a circumscribed, conical, and hyperkeratotic epidermis projected from the skin surface. Cutaneous horn is described in domestic animals with unknown etiology in some of them. In this report, this lesion was observed on the apex of the ear in a female Pakistani goat. The size of the cutaneous horn was 12 cm length. It was removed under local anesthesia and fixed in 10% neutral buffered formalin. Histopathologic examination showed well-differentiated keratinocytes without atypical keratinocytes. Thick dermal collagenous bundles were observed in the horn base. Mononuclear cell inflammation was observed around the vessels of the dermis in the base of lesion.

Cutaneous horn arising from a basal cell carcinoma of forehead: a case report

<p class="abstract">The term cutaneous horn or “cornu cutaneum” is used to describe a well circumscribed usually conical hyperkeratotic mass arising from another cutaneous lesion. Several lesions have been reported to occur at the base of the keratin mass. Here we report a rare case of cutaneous horn arising from a basal cell carcinoma (BCC) over the forehead of a 52 year old female patient.</p><p class="abstract"> </p>

Cornu cutaneum -a rare eyelid tumour

Cutaneous horn or cornu cutaneum is a rare skin tumour affecting sunlight exposed areas in elderly males. It can develop as single or multiple lesion. It may develop from various skin lesions which varies from benign to malignant. Keywords: Cornu cutaneum, Cutaneous horn, Keratinised material

Cutaneous horn developing over a verrucous carcinoma: a rare entity with an unusual presentation

Cutaneous horn (cornu cutaneum) is a very rare lesion resembling the horn of an animal. It consists of a projectile, conical, dense, hyperkeratotic nodule. The horn is frequently conical, made of stratum corneum. Diagnosis is easily made clinically and can be confirmed by histopathology. We report a case of 65 year old female, who had a cutaneous horn for over 5 months, which turned out to be growing over a verrucous carcinoma.

Giant Cornu Cutaneum Superimposed on Basal Cell Carcinoma.

Cornu cutaneum (CC) is a clinical term that describes the horn-like keratotic lesions extending vertically from the skin. Benign, premalignant or malignant lesions may be present at the base of CC. Seborrhoeic keratosis and squamous cell carcinoma (SCC) are the most commonly reported benign and malignant forms, respectively. Basal cell carcinoma (BCC) at the base is rare. Here, we report on an 85-year old female patient having multiple CC lesions, one being giant on her face and two of the lesions diagnosed with BCC at the base. This case is of significance due to the presence of giant and multiple CC and detection of BCC at the base of more than one lesion. This present case indicates the need for the treatment of possible malignant lesions underlying CC in the elderly by total surgical excision.

Photoletter to the editor: Giant cutaneous horn associated with squamous cell carcinoma.

A 90-year-old patient presented with a large cutaneous horn (cornu cutaneum) of nine-year duration arising at her right cheek. The lesion was removed by surgery. Histology was reported as cornu cutaneum with a well-differentiated squamous cell carcinoma at its base. Cutaneous horn is morphological designation for protuberant mass of keratin that resembles the horn of an animal. Such lesions appear on sun-exposed skin areas like upper parts of the face and ears in elderly patients. Large cutaneous horns (> 1 cm) tend to be more commonly associated with squamous cell carcinoma compared to smaller cutaneous horns, particularly when present on the face.

Diagnosis and Management of Cornu Cutaneum of Nasal Vestibule: A Rare Case Report.

Cornu cutaneum is a relatively uncommon projectile, irregular, hyperkeratotic nodule that can be seen in places such as scalp, forehead, eyelids, ear, nose, lips, and upper extremities which are subjectable to sunlight. Treatment is surgery with radical margins. Excisional biopsy is enough for treatment of the lesion on head and face. However, there is only little literature about cornu cutaneum on the nasal vestibule. We present an 82-year-old male patient with a necrotic, irregular shaped lesion with pedicle on the left nasal vestibule excised and diagnosed as cornu cutaneum.

Misdiagnosis of Melanoma: A 7 Year Single-Center Analysis

Background: Despite implementation of dermoscopy, the accuracy of diagnosing melanoma remains a challenge. The aim of this study was to retrospectively analyze cases of histologically confirmed melanoma, which were incorrectly diagnosed during initial evaluation. Methods: A retrospective analysis of histologically diagnosed melanomas referred to the F.D. Roosevelt Hospital between 2008 and 2014, in which the initial diagnosis was incorrect. We evaluated their histological characteristics, localization of the lesion as well as the specialty of the physician who made the incorrect diagnosis. Results: From a total of 936 histologicaly confirmed melanomas, 150 (16%) were diagnosed incorrectly. Of those, 26 (17.3%) were melanoma in situ. The average value of the Clark Is level of true melanomas was 3.49, with an average Breslow thickness of 3.09 mm. Sixty of the melanomas developed on the trunk and 55 on the extremities. Incorrectly diagnosed lesions included nevi in 80 cases, basal-cell carcinoma in 32, non-specific tumor in 16, pyogenic granuloma in 5, squamous-cell carcinoma in 5, haemangioma in 5, seborrheic keratosis in 4 cases, and histiocytoma, keratoacanthoma and cornu cutaneum each in 1 case. The diagnosis of melanoma was missed by a dermatologistin 85 cases, by a surgeon in 38 cases, and by a general practitioner in 2 cases. In the remaining 25 cases we were unable to identify the specialty of the physician who made the wrong diagnosis. Conclusion: This analysis revealed a high proportion of melanomas that were missed during initial evaluation. The outcome of this study points to the need for better education in the field of diagnostics of melanocytic lesions for dermatologists, surgeons and primary care physicians. In addition, there is a need for periodic evaluation of diagnostic accuracy of dermatology centers using various tools (e.g. Melanoma Diagnostic Index). Continually increasing awareness of malignant melanoma in the general public is also very important.

A rare case of cornu cutaneum in Indian buffalo

A rare case of cornu cutaneum on the forehead of a six-year-old buffalo was diagnosed. Grossly, the growth was grayish black in colour, firm and hard to touch projected above skin like an accessory horn. Histopathologically, it revealed papillary projections of epidermis with hyperkeratosis and acanthosis, resembling a papillomatous growth.

An innocent giant.

A cutaneous horn (cornu cutaneum) is a protrusion from the skin composed of a cornified material. It may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous dermatoses. In a 24-year-old female, a giant cutaneous horn arising from a seborrheic keratosis located on the leg is presented. This case has been reported to emphasize that a giant cutaneous horn may also occur in young patients, even in photoprotected areas, and are not always associated with malignancy.