Cutaneous horns, also known by the Latin name cornu cutaneum, are unusual keratinous skin tumors with the appearance of horns, or sometimes of wood or coral. Formally, this is a clinical diagnosis for a "conical projection above the surface of the skin."[1] They are usually small and localized but can, in very rare cases, be much larger. Although often benign, they can also be malignant or premalignant.[2]

Cutaneous horn
Actinic keratosis, pre-cancerous area of thick, scaly, or crusty skin (Below) with cutaneous horn tissue (above)

Signs and symptoms

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The lesion at the base of the keratin mound is benign in the majority of cases. Malignancy is present in up to 20% of cases, with squamous-cell carcinoma being the most common type. The incidence of squamous-cell carcinoma increases to 37% when the cutaneous horn is present on the penis.[3]

 
Cutaneous horn in right ear

Cause

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The cause of cutaneous horns is still unknown, but it is believed that exposure to radiation can trigger the condition. This is evidenced by a higher rate of cases occurring on the face and hands, areas that are often exposed to sunlight. Moreover, there is a higher prevalence in Asian countries with a warm climate. Other cases have reported cutaneous horns arising from burn scars.[4] As with many other wart-like skin conditions, a link to the HPV virus family, especially the HPV-2 subtype has been suggested.[5]

Diagnosis

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Histologically they are characterized by compact proliferation of keratin

Treatments

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Treatment is surgical excision

Notable cases

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  • Zhang Ruifang, aged 101 (as of 2010), living in Linlou Village, Henan province, China, has grown a cutaneous horn on her forehead, resembling what those who have examined her and her family call "Devil's Horns". Notably, this growth has expanded to reach a total of 6 cm (2.5 inches) in length. Another is forming on the opposite side of her forehead.[6]
  • Liang Xiuzhen, aged 87 (as of 2015) living in Guiyan village in Ziyang City, Sichuan province, China, grew a 13-centimetre (5.1-inch) pointed horn from her forehead, earning her the nickname "Unicorn Woman".[7]
  • Huang Yuanfan, aged 84 (living in Ziyuan, China).[8]
  • Shyam Lal Yadav, aged 74 (living in Madhya Pradesh, India) grew a 10-centimetre (4-inch) horn after an accident, and later had it surgically removed.[9]
  • Madame Dimanche ("Widow Sunday"), a French woman living in Paris in the early 19th century, grew a 24.9-centimetre (9.8-inch) horn from her forehead in six years from the age of 76 before it was successfully removed by French surgeon Br. Joseph Souberbeille (1754–1846). A wax model of her head is on display at the Mütter Museum, The College of Physicians of Philadelphia, US.[10]

See also

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References

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  1. ^ Copcu, Eray; Sivrioglu, Nazan; Culhaci, Nil (2004). "Cutaneous horns: are these lesions as innocent as they seem to be?". World Journal of Surgical Oncology. 2: 18. doi:10.1186/1477-7819-2-18. PMC 421749. PMID 15176977.
  2. ^ Yu, R.C.H.; Pryce, D.W.; MacFarlane, A.W.; Stewart, T.W. (1991). "A histopathological study of 643 cutaneous horns". British Journal of Dermatology. 124 (5): 449–52. doi:10.1111/j.1365-2133.1991.tb00624.x. PMID 2039721. S2CID 73180732.
  3. ^ Solivan, GA; Smith, KJ; James, WD (1990). "Cutaneous horn of the penis: Its association with squamous cell carcinoma and HPV-16 infection". Journal of the American Academy of Dermatology. 23 (5 Pt 2): 969–72. doi:10.1016/0190-9622(90)70315-9. PMID 2172337.
  4. ^ Nthumba, Peter M (2007). "Giant cutaneous horn in an African woman: a case report". Journal of Medical Case Reports. 1: 170. doi:10.1186/1752-1947-1-170. PMC 2225419. PMID 18053226.
  5. ^ Wang, W; Wang, C; Xu, S; Chen, C; Tong, X; Liang, Y; Dong, X; Lei, Y; Zheng, X (2007). "Detection of HPV-2 and identification of novel mutations by whole genome sequencing from biopsies of two patients with multiple cutaneous horns". Journal of Clinical Virology. 39 (1): 34–42. doi:10.1016/j.jcv.2007.01.002. PMID 17368088.
  6. ^ Writers, Staff. (2010-03-09) Chinese woman Zhang Ruifang, aged 101, grows 'devil' horn Archived 2011-06-14 at the Wayback Machine. Herald Sun. Retrieved on 2010-10-27.
  7. ^ "'Unicorn woman' set to have 'horn' removed from head after 13cm spike stops OAP sleeping". Mirror Online. 27 August 2015. Retrieved 27 August 2015.
  8. ^ "China's Huang Yuanfan Sprouts 3-Inch Horn From Head". 10 January 2011. Archived from the original on 22 February 2011.
  9. ^ "74-year-old MP man grows devil's horn after injury". India Today. 14 September 2009.
  10. ^ The Mütter Museum. Corkscrew-balloon.com (2003-05-26). Retrieved on 2010-10-27.

Further reading

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