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Cutaneous Horn

Background

Cutaneous horn is a clinical diagnosis referring to a conical projection of cornified material above the surface of the skin that resembles a miniature horn. Historically, it is also referred to by its Latin name, cornu cutaneum, and less commonly and more eponymously, as cornu cutaneum of Rokitansky, after the German pathologist Baron Carl von Rokitansky.

The horn is composed of compacted keratin. The base of the horn may be flat, nodular, or crateriform. Various histologic lesions have been documented at the base of the keratin mound, and histologic confirmation is often necessary to rule out malignant changes. No clinical features reliably distinguish between benign and malignant lesions. Tenderness or bleeding at the base and lesions of larger size, however, favor malignancy.

Historically, London surgeon Everard Home was credited with the earliest descriptions of cutaneous horns in 1791. However, cases from as early as the 16th and 17th centuries have been described in the medical literature. Most notable among these was by the Danish anatomist Thomas Bartholin in 1670.

The image below depicts a typical presentation of a cutaneous horn.

A typical presentation of a cutaneous horn on the

A typical presentation of a cutaneous horn on the ear.

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See Nonmelanoma Skin Cancers You Need to Know, a Critical Images slideshow, to help correctly identify these lesions.

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