Cutaneous horn: causes, symptoms, diagnosis, treatment

The cutaneous horn is characterized by the appearance of a dense horny mass protruding above the surface of the skin, often cylindrical in shape. It often develops in the elderly. Recently, the term "cutaneous horn" is considered to be collective, as it can develop in various processes, including benign tumors, such as warts, keratopapillomas, keratoacanthomas. But most often it is observed with actinic keratosis and the initial stages of squamous cell carcinoma. In this regard, in each case of the cutaneous horn, a thorough histological examination is required.

Causes and pathogenesis of cutaneous horn. The cutaneous horn arises from the proliferation of the epidermis, especially against the background of senile keratosis, common warts and keratoacanthoma. Among the provoking factors distinguish microtraumas, insolation, viral infections, etc.

Symptoms of cutaneous horn. Limited proliferation of horny masses resembling horns of animals, mostly conical in shape, usually straight, yellowish-brownish or dark in color, dense or dense in consistency. The surface is smooth or uneven with multiple furrows. Inflammatory phenomena are detected only in close proximity to the base of the horn in the form of a narrow erythematous corolla. Horny neoplasms can reach very large sizes, rarely occur in small lengths. Overgrowth occupies more extensive areas over the surface, but in these cases the size of the apex is considerably narrower than the base. The height of the cutaneous horn can serve, to a certain extent, as a prognostic sign. Thus, the skin horn, whose size does not exceed one centimeter, usually develops against basiloma and senile keratoma. At the base of the larger horn, histologically, seborrheic warts, keratoacanthoma, horny papilloma are identified. On the red border of the lips, the height of the cutaneous horn usually does not exceed 0.5-1 cm. The lower lip is affected much more often, various pathological processes (red and tubercular lupus, leukoplakia, etc.) often serve as a backdrop.

The cutaneous horn is usually single, multiple neoplasms are a rarity. It develops somewhat more often in women, especially the elderly, is located mainly on the face (ears, cheeks) and the scalp. Rarely the cutaneous horn is located on mucous and semilucid. The course and prognosis depend on the dermatosis, against which the skin horn developed. The most common cancer is found in cases of the cutaneous horn, which developed against the background of senile keratosis, not counting those cases when it appeared in the zone of tumors.

Histopathology. There is pronounced hyperkeratosis, papillomatosis; in the base, as indicated, there can be a wide variety of processes - precancerous, malignant and benign tumors, infectious, caused by trauma, etc.

Pathomorphology. There is markedly expressed hyperkeratosis with the formation of layered masses, in the region of the base - acanthosis with hypertrophy of the granular layer. With malignancy in acanthosis, cell polymorphism similar to that of actinic keratosis can be seen, many mitoses, including pathological ones.

Differential diagnosis. Differentiate the cutaneous horn is necessary from warts, calluses, fibroids, angiokeratoma limited unimaginative, warty nevi, verruzed psoriasis.

Treatment of cutaneous horn. Surgical excision is performed.

[1], [2], [3], [4], [5]