Giant-Sized Cutaneous Horns

Abstract 

Conical growths called cutaneous horns can be found in a variety of body locations, ideally, those that receive the most sun exposure. Since lesions may contain both premalignant and malignant entities, they are clinically significant. Histologically, they are made of hyperkeratotic material and resemble animal horns, but they are not the same since they lack the central bone core that sets animal horns apart. We discuss the case of a 51-year-old man who has had a conical projection above the middle of his head for 8 years. The horn was detached 8 months before the patient visited us, but it has since grown again, and it was clinically determined to be a cutaneous horn. Spacemen were taken for histological analysis after the horn and base were removed, and the results revealed no cancerous alterations. The preferred course of treatment for cutaneous horn is excision of the lesion with sufficient margins, followed by histological confirmation.

Introduction

A cutaneous horn is a medical term for a conical growth of cornified tissue above the skin's surface that resembles an animal horn. Contrary to animal horns, which typically have an osseous cast, cutaneous horns are made entirely of cornified, proliferating keratinocytes. Africans rarely experience it, while white people are more likely to. Any portion of the body can develop a cutaneous horn, though 30% do so in sun-exposed locations like the face and scalp. In 61.1%, 23.3%, and 15.7% of instances, respectively, the lesions are believed to have benign, premalignant, and malignant potential as their origins. 

Case Presentation 

A 51-year-old man arrived with a scalp horn that was eight years old. It began as an itchy lesion that progressively grew in size. He attended various medical institutions where they gave topical treatments, but it didn't go away and kept becoming bigger. Eventually, it started to hurt when touched or shaken. He was seen at a peripheral hospital about 8 months before arriving at our clinic, where the horn was removed but later regrow to the proper size. He wore a cap and managed to hide the horn. When examined, the man was awake and appeared to be in good condition. He had a hard horn on his mid-scalp that was dry, hard, attached to the skin at its base, tender to movement, moveable on either side, and the skin color next to the lesion was unaltered. A simple x-ray of the head revealed that the bony section was unaffected. A cutaneous horn clinical diagnosis was made. The patient was encouraged to have an excision biopsy, and he gladly agreed because he had long sought a conclusive course of treatment without result.  Under local anesthesia, a large local excision was performed with sufficient margins, and the patient experienced a wonderful recovery. The spacemen were examined histologically, and it was discovered that they have stratified hyperkeratotic and acanthotic squamous epithelium without malignant alterations.

Conclusion

Cutaneous horns are rare cutaneous conditions that are likely disregarded. Although the majority are benign, the possibility of cancer should not be disregarded. The typical course of treatment is an excision biopsy with sufficient margins. The course of treatment after excision will be decided by a histological evaluation of the removed spacemen.