Cornu Cutaneum Research Articles

Mythology to reality: Case report on a giant cutaneous horn of the scalp in an African American female

We present a case study of a patient with a rare and disfiguring dermatologic condition known as cornu cutaneum, or giant cutaneous horn (GCH). While this condition has been well described in people of European and Asian ancestry, its presence in African populations is perceived to be rare and has not been reported in the literature until recently. We present the case of cornu cutaneum in a woman of African descent, contributing to the recent evidence that this condition may not be as rare in African populations as believed. Etiologic factors, epidemiology and management are also reviewed.

A large cutaneous horn of the glans penis: a rare presentation.

Cutaneous horn (cornu cutaneum) is a relatively uncommon lesion consisting of a projectile, conical, dense, hyperkeratotic nodule which resembles the horn of an animal. Cutaneous horns most frequently occur in sun-exposed parts and are typically found in the face and the scalp, but may also occur on the hands, eyelids, nose, chest, neck, shoulder and penis. Their occurrence on the penis is uncommon. We report a 42-year-old man presenting with penile cutaneous horn. The association with malignancy on the penis makes proper identification of these lesions essential. Standard treatment involves local excision, but the presence of malignancy mandates a partial penectomy.

Cornu Cutaneum of the Penis: A Case Report

A 60-year-old male presented with a cornu cutaneum (cutaneous horn) on the penis. Histopathology showed a well-differentiated squamous cell carcinoma. Majority of the lesions at the base of the keratin mound are benign. The incidence of malignancy increases in cornu cutaneum of the penis with squamous cell carcinoma being the most common type.

Cornu Cutaneum in a Patient of African Descent

Cornu cutaneum, or giant cutaneous horn (GCH), is an uncommon but disfiguring lesion that may cause the patient considerable distress. The aesthetic implications of such lesions are obvious. The etiology and treatment of GCH are more obscure, both to patients and physicians alike. We present a female patient of African descent with a GCH of the scalp, which represents the first such case to our knowledge outside Africa. The etiology and management of GCH in all races are reviewed.

Detecção precoce de neoplasias cutâneas em cuidados de saúde primários - Relato de uma experiência

Background: Skin cancer has an elevated prevalence in Portugal. It is estimated that the incidence of melanoma is 8/100,000 persons/year and the incidence of epitheliomas is 100/100,000 persons/year. The incidence of melanoma has been increasing by 6 to 7% per year. Twenty percent of patients with melanoma will die as a result of their disease and half of these patients will die before the age of 40. The progressive increase in incidence is due not only to an increase in new cases, but also due an increase in consultations. Methodology: This paper reports on a 22-month-long experience (July 2008 to May 2010) of the excision of small skin lesions through minimally invasive surgical procedures. 282 patients of all ages were treated. Of these 58% (164) were female. A total of 341 procedures were performed. Histological examination for diagnostic purposes was performed in 49.8 % (170). Results: The most common lesions observed were epidermal cysts, intradermal melanocytic nevi and compound melanocytic nevi. The following pre-cancerous lesions were also observed: actinic keratosis, cornu cutaneum, HPV lesions, atypical melanocytic nevi, and congenital melanocytic nevus. The following cancerous lesions were observed and excised: squamous cell carcinoma in situ, basal cell carcinoma and melanoma. In all cases of precancerous lesions, complete excision with clear margins was confirmed by histology. All cases of cancerous lesions were referred to secondary care for follow-up and continued treatment. Discussion: It is possible to perform early detection and treatment of skin cancer in primary care. The accessibility of this service is appreciated by patients, allowing for shorter distances travelled to obtain care and reduced waiting times. In future studies, cost-effectiveness and impact on the health of the population should be addressed.

Cornu cutaneum-like HPV 45 positive subungual squamous cell carcinoma

A cornu cutaneum (cutaneous horn) is a clinical descriptive term referring to a skin tumor having the appearance of an animal horn. Histopathologically, the lesion may be associated with several different tumors. Along with some benign entities such as warts or seborrheic keratoses, a cutaneous horn may be also associated with actinic keratoses, Bowen disease and squamous cell carcinoma. When an underlying malignancy is present, the entire tumor must be removed with careful control of margins. We report a case of a 68-year-old man with a cornu cutaneum-like HPV 45 positive sub-ungual squamous cell carcinoma on the left second toe.

Plantar Cornu Cutaneum Associated with Cutaneous Myxoma

Cutaneous horns are rare in black patients probably as a result of the rarity of sun induced associated skin lesions. However reports of these lesions are filtering in from Africa. In this paper we report an unusual case on the sole of the foot in a native African from Nigeria. This is probably the first documentation of the lesion on the sole of the foot in the world literature.

A case of Bowen's disease associated with cornu cutaneum

A case of Bowen's disease associated with cornu cutaneum

Facial cutaneous horn and skin cancer: Report of two cases

Cornu cutaneum horn is a lesion with hyperkeratosis resembling that of an animal horn and its length varies from a few millimeters to several centimeters. The horn is most commonly located in the face, ears and other sun exposed areas. Cornu cutaneum occurs in association with, or as a response to a wide variety of underlying benign, pre-malignant, and malignant cutaneous diseases. Two cases with facial cutaneous horn with underlying squamous cell carcinoma and basal cell carcinoma is reported.

Cutaneous Horn of the Eyelid in a 4-Year-Old Child

Cutaneous horn or cornu cutaneum is an unspecific term used for the clinical description of horn-like protrusions consisting of keratin-like material [1]. A cutaneous horn is an uncommon neoplastic clinical sign mainly affecting elder caucasians on sun-exposed skin areas. A variety of different malignant, premalignant, and benign pathologies may lead to the development of a cutaneous horn. Horns should be differentiated by a pathohistological examination of basal tissue of the protrusion [1]. A cutaneous horn seems to be an extremely rare clinical finding in children. Only four cases have been documented in literature [2] [3] [4] [5]. Three of these were localized on the eyelids [2] [3] [4]. Here we report on the fourth case of a cutaneous horn on the eyelid of a child and present the second histopathological description of this clinical entity so far.

Squamous cell carcinoma presenting as cutaneous horn in diabetic patient- single case report & review

65 years old, diabetic female presented with deep punched out, painless, foul smelling ulcer in the mid lateral aspect of right leg for 2 years duration. The ulcer histopathologically confirmed to show Squamous Cell Carcinoma SCC, developed in a base of sloughed large horn of 13 years long duration. The condition as mentioned is extremely rare, and most probably mismanaged at presentation, as the important issue in this condition is not the horn itself, which is just dead keratin, but rather the nature of the underlying disease, although the horns are usually benign and that's why the case is reported. Keywords: Cutaneous horn; Cornu cutaneum; Squamous Cell Carcinoma; Diabetes Mellitus. Sudanese Journal of Dermatology Vol. 4 (2) 2006: pp. 86-91

Cornu cutaneum at an unusual site

AbstractCutaneous horn (cornu cutaneum) is a clinical diagnosis referring to a conical projection above the surface of the skin that resembles a miniature horn. The base of the horn may be flat, nodular or crateriform. The horn is composed of compacted keratin. Various histologic lesions have been documented at the base of the keratin mound and histological confirmation is often necessary to rule out malignant changes. Tenderness at the base of the lesion and lesions of larger size favour malignancy. Malignancy is present in 16-20% of the cases with squamous cell carcinoma being the most common type. We report a young male patient with a keratin horn on the right index finger tip.

Cornu cutaneum at an unusual site

Cutaneous horn (cornu cutaneum) is a clinical diagnosis referring to a conical projection above the surface of the skin that resembles a miniature horn. The base of the horn may be flat, nodular or crateriform. The horn is composed of compacted keratin. Various histologic lesions have been documented at the base of the keratin mound and histological confirmation is often necessary to rule out malignant changes. Tenderness at the base of the lesion and lesions of larger size favour malignancy. Malignancy is present in 16-20% of the cases with squamous cell carcinoma being the most common type. We report a young male patient with a keratin horn on the right index finger tip.

Cutaneous horns of the eyelid: a clinicopathological study of 48 cases.

Cutaneous horn (cornu cutaneum) is a morphological designation for a protuberant mass of keratin that resembles the horn of an animal. It results from unusual cohesiveness of keratinized material from the superficial layers of the skin or implanted deeply in the cutis. This lesion may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous conditions. A retrospective analysis of 48 cases of cutaneous horns of the eyelid treated between 1992 and 2002 has been performed. Twenty-four men and 19 women, with a mean age of 62 years (range 16-90), were treated by surgery. Histologically, 77.1% were associated with benign specimens at the base pathology, 14.6% were premalignant, and finally, 8.3% were caused by malignant skin tumors. The most common lesion was seborrheic keratosis among the benign lesions, actinic keratosis among the premalignant ones, and basal cell carcinoma and squamous cell carcinoma among the malignant ones. Cutaneous horns usually appear on exposed skin areas in elderly men. The important issue in this condition is not the horn itself, which is just dead keratin, but rather the nature of the underlying disease, although the horns are usually benign.

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

BackgroundCutaneous horns (cornu cutaneum) are uncommon lesions consisting of keratotic material resembling that of an animal horn. Cutaneous horn may arise from a wide range of the epidermal lesions, which may be benign, premalignant or malignant.Patients and methodsIn 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.ResultsThere 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.ConclusionCutaneous 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.

Cryosurgery in the treatment of cutaneous malignant melanoma

Cryosurgery can be used for the treatment of benign and malignant tumors in various medical disciplines. In dermatology, cryosurgery can be employed, for example, for solar keratosis, cornu cutaneum, leukoplakia, extramammary Paget's disease, keratoacanthoma, spinocellular carcinoma, and basal-cell cancer. The possible application of cryosurgery for the treatment of malignant melanoma is based on the following facts and assumptions: 1. 1. The cold-induced destruction of melanoma cells occurs at temperatures of −4 ° C to −7 ° C, while connective tissue cell destruction is only observed at temperatures below −20 ° C. 2. 2. As discussed in Chapter 3 “Electron Microscopic Investigations of the Cryolesion,” electron microscopic studies of cryolesions have shown that cell membranes, intracellular organelles, and the nucleus are destroyed. 3. 3. There are indications that humoral as well as cell-mediated immune responses are induced by cryotherapy. The destroyed tumor remains in situ, giving rise to the possibility of prolonged exposure (about 72 hours) of tumor antigens to the host's immune system. As a consequence, it can be postulated that tissue destroyed by freezing is capable of immune system stimulation in two ways. The first is via the release of intracellularly sequestered auto-antigens into the bloodstream as a result of cell membrane destruction. Once in the bloodstream, contact is made with the immune system which does not recognize these antigens as “self.” The second alternative is an alteration of the membrane molecular surface structure to such an extent that the immune system mistakes them as foreign antigens and mounts an immune response. The higher the cooling intensity or the larger the cryolesion, the more antigenic material will be released, apparently leading to a greater “immunologic stimulation” of the host. 1,3 The use of cryostimulation as an adjuvant, active and specific immunotherapy in addition to the cryosurgical destruction of malignant melanoma is, therefore, of considerable interest. There are two different possibilities for application of cryosurgery in CMM: cryosurgery of primary malignant melanoma, and palliative cryosurgery of metastases from stages II–IV.

PRECANCEROUS DERMATOSES: A STUDY OF TWO CASES OF CHRONIC ATYPICAL EPITHELIAL PROLIFERATION

THE various cutaneous conditions that may precede the development of cancer have been sometimes grouped, more or less loosely, under the title Precancerous Conditions, Precancerous Keratoses, etc. Thus, Dubreuilh1 in his paper Des hyperkeratoses circonscrites, read at the International Congress of Dermatology in London, 1896, discusses under the heading the following affections: cornu cutaneum, keratoma senile, xeroderma pigmentosum, arsenical cancer, chimneysweep's cancer, cancer in workers in paraffine and tar, and leucokeratoses. Keratosis follicularis (Darier's disease) and Paget's disease, are cited as affections which, although not strictly coming under the head of keratoses, have a distinct analogy with the precancerous keratoses. Hartzell 1 , in a paper read at a meeting of the American Dermatological Association in Washington in 1903, touches upon various affections of the skin such as tuberculosis, syphilis and various benign new growths, that may be followed by cancer, together with the forms of keratoses just mentioned.

Centennial paper. May 1912 (J Cutan Dis Syph 1912;30:241-255). Precancerous dermatoses: a study of two cases of chronic atypical epithelial proliferation. By John T. Bowen, M.D., Boston

THE various cutaneous conditions that may precede the development of cancer have been sometimes grouped, more or less loosely, under the title "Precancerous Conditions," "Precancerous Keratoses," etc. Thus, Dubreuilh1 in his paper "Des hyperkératoses circonscrites," read at the International Congress of Dermatology in London, 1896, discusses under the heading "precancerous keratoses," the following affections: cornu cutaneum, keratoma senile, xeroderma pigmentosum, arsenical cancer, chimneysweep's cancer, cancer in workers in paraffine and tar, and leucokeratoses. Keratosis follicularis (Darier's disease) and Paget's disease, are cited as affections which, although not strictly coming under the head of keratoses, have a distinct analogy with the precancerous keratoses. Hartzell¹, in a paper read at a meeting of the American Dermatological Association in Washington in 1903, touches upon various affections of the skin such as tuberculosis, syphilis and various benign new growths, that may be followed by cancer, together with the forms of keratoses just mentioned.

Studies in Immunodermatology

Biopsies of skin lesions from 50 cases of psoriasis and from 42 cases with other dermatoses were studied by the methods described in the foregoing report, that is by the four-compartment immunofluorescent (IF) system for detecting stratum corneum autoantibodies and <i>in vivo</i> binding of IgG in psoriatic scales at the site of the stratum corneum antigen. They were also studied histologically. Early and fully developed psoriatic lesions tended to have more widespread deposits of IgG in the stratum corneum than receding lesions. In biopsies with widespread IgG deposits the stratum corneum antigen usually could not be demonstrated because of blocking by <i>in vivo</i> bound IgG. Of the 42 control biopsies of skin lesions from patients with other dermatoses which were examined with this system two gave the IF staining patterns which were seen most commonly in psoriatic lesions. In these two cases strong widespread IgG deposits occurred in compartment 3, and 4 was very similar to compartment 3. One case was diagnosed as lichen planus and one as cornu cutaneum. Comparisons of the IF findings in psoriatic and control lesion biopsies indicate that significantly more of the former have: (1) IgG deposits at the combining sites of stratum corneum antibodies (92 vs. 50%) and (2) no demonstrable stratum corneum antigen because of ‘blocking’ by <i>in vivo</i> bound IgG, i.e. compartment 3 like 4 (56 vs. 7%). A highly significant inverse relation between the <i>in vivo</i> deposits of IgG and demonstrability of stratum corneum antigen appeared regardless of the clinical condition. This observation lends support to the view that the IgG which is bound to the sites of the stratum corneum antigen in skin lesions may in fact be <i>in vivo</i> bound stratum corneum autoantibody.

Basal cell carcinoma at the base of cutaneous horn (cornu cutaneum)

Basal cell carcinoma at the base of cutaneous horn (cornu cutaneum)