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CASE REPORT
Year : 2007  |  Volume : 52  |  Issue : 1  |  Page : 59-60
Sebaceous horn: An interesting case


NMC SP. Hospital, AL Nahada, Dubai, United Arab Emirates

Correspondence Address:
Sanjay Saraf
NMC SP. Hospital, AL Nahada, Dubai
United Arab Emirates
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DOI: 10.4103/0019-5154.31929

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   Abstract 

Sebaceous horn or cutaneous horn of the nose is a rare clinical entity. A case of a giant sebaceous horn of the nose presenting in an elderly male, which was successfully excised and reconstructed is reported.


Keywords: Cornu cutaneum, cutaneous horn


How to cite this article:
Saraf S. Sebaceous horn: An interesting case. Indian J Dermatol 2007;52:59-60

How to cite this URL:
Saraf S. Sebaceous horn: An interesting case. Indian J Dermatol [serial online] 2007 [cited 2014 Jul 26];52:59-60. Available from: http://www.e-ijd.org/text.asp?2007/52/1/59/31929



   Introduction Top


Cutaneous horn ( cornu cutaneum ) is a relatively uncommon lesion consisting of a projectile, conical, dense, hyperkeratotic nodule, which resembles the horn of an animal.[1] The horn is composed of compacted keratin. Cutaneous horns most frequently occur in sun-exposed parts and are typically found on the face and scalp, but may also occur on the hands, penis, eyelids, nose, chest, neck and shoulder. The cutaneous horns are usually benign, however, malignant or premalignant lesions might be associated with it.[2] Because of their malignant potential, the lesions must always be considered for histopathological evaluation.


   Case Report Top


A 92-year-old male presented with a raised, painless growth over the tip of nose of more than six years duration. The clinical examination demonstrated a cone-shaped keratotic cutaneous horn [Figure - 1]. After careful and detailed physical examinations the lesion was excised and reconstructed with lateral nasal flap (Miter flap) with satisfactory result [Figure - 2]. Specimen was evaluated microscopically. Microscopically the horn consisted of a mixture of squamous epithelial cells and tricholemmal keratinized debris. The patient had history of long-term sun exposure due to farming activities and had solar keratosis on face and extremities. The follow-up was uneventful without signs of recurrence.


   Discussion Top


A cutaneous horn ( cornu cutaneum ) is a protrusion from the skin consisting of cornified material resembling an animal horn in miniature. However, the animal horns are composed of superficial hyperkeratotic epidermis, dermis with centrally positioned bone. No such well-formed bone is observed in the human horns. The earliest well-documented case of cornu cutaneum from London in 1588 is of Mrs. Margaret Gryffith, an elderly Welsh woman. However, earliest observations on cutaneous horns in humans were described by the Everard Home in 1791.[3] Farris from Italy first described the well-documented case report with adequate histology of gigantic horn in a man.[4] These horns may arise from a variety of benign, premalignant or malignant epidermal lesions. Most commonly, they are single and arise from a seborrheic keratosis lesion.[5] According to a largest study by Yu et al ,[2] 61% of cutaneous horns were derived from benign lesions and 39% were derived from malignant or premalignant epidermal lesions. Two other larger studies on cutaneous horn also showed that 23-37% of horns were associated with actinic keratosis or Bowen's disease and another 16-20% with malignant lesions.[2],[6] The important consideration in these cases is not the horn, but the underlying pathology which may be benign (seborrheic keratosis, viral warts, histiocytoma, inverted follicular keratosis, verrucous epidermal nevus, molluscum contagiosum, etc.), premalignant (solar keratosis, arsenical keratosis, Bowen's disease) or malignant (squamous cell carcinoma, rarely, basal cell carcinoma, metastatic renal carcinoma, granular cell tumor, sebaceous carcinoma or Kaposi's sarcoma.[7] Histopathological examination, specially of the base of the lesion[1],[8].[9] is necessary to rule out associated malignancy and full excision and reconstruction is the treatment of choice.

The cutaneous horns are predominantly benign lesions; however possibility of malignant potential should always be kept in mind.

 
   References Top

1.Korkut T, Tan NB, Oztan Y. Giant cutaneous horn: A patient report. Ann Plast Surg 1997;39:654-5.  Back to cited text no. 1  [PUBMED]    
2.Yu RC, Pryce DW, Macfarlane AW, Stewart TW. A histopathological study of 643 cutaneous horns. Br J Dermatol 1991;124:449-52.   Back to cited text no. 2  [PUBMED]    
3.Bondeson J. Everard Home, John Hunter and Cutaneous horns: A historical review. Am J Dermatopathol 2001;23:362-9.   Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Farris G. Histological considerations on a case of a voluminous cutaneous horn. Minerva Dermatol 1953;28:159-65.   Back to cited text no. 4  [PUBMED]    
5.Thappa DM, Laxmisha C. Cutaneous horn of eyelid. Indian Pediatr 2004;41:195.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]  
6.Schosser RH, Hodge SJ, Gaba CR, Owen LG. Cutaneous horns: A histopathologic study. South Med J 1979;72:1129-31.  Back to cited text no. 6  [PUBMED]    
7.Copcu E, Sivrioglu N, Culhaci N. Cutaneous horns: Are these lesions as innocent as they seem to be? World J Surg Oncol 2004;2:18.   Back to cited text no. 7  [PUBMED]  [FULLTEXT]  
8.Gould JW, Brodell RT. Giant cutaneous horn associated with verruca vulgaris. Cutis 1999;64:111-2.  Back to cited text no. 8  [PUBMED]    
9.Kastanioudakis I, Skevas A, Assimakopoulos D, Daneilidis B. Cutaneous horn of the article. Otolaryngol Head Neck Surg 1998;118:735.  Back to cited text no. 9  [PUBMED]  [FULLTEXT]  


    Figures

  [Figure - 1], [Figure - 2]

This article has been cited by
1 A Large Cutaneous Horn of the Glans Penis: a Rare Presentation
Vikas Gupta,Vanilla Chopra,Sidharth Verma
Indian Journal of Surgery. 2013;
[Pubmed]
2 Short Communication; Cutaneous horn of scalp
Salati, S.A., Rather, A.
Journal of Pakistan Association of Dermatologists. 2010; 20(4): 249-250
[Pubmed]



 

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    Abstract
    Introduction
    Case Report
    Discussion
    References
    Article Figures

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