cutaneous horn

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| name = Cutaneous horn

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| image = SkinTumors-P5280062.JPG

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

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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."{{cite journal |last1=Copcu |first1=Eray |last2=Sivrioglu |first2=Nazan |last3=Culhaci |first3=Nil |title=Cutaneous horns: are these lesions as innocent as they seem to be? |journal=World Journal of Surgical Oncology |volume=2 |page=18 |year=2004 |pmid=15176977 |pmc=421749 |doi=10.1186/1477-7819-2-18 |doi-access=free }} 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.{{cite journal |last1=Yu |first1=R.C.H. |last2=Pryce |first2=D.W. |last3=MacFarlane |first3=A.W. |last4=Stewart |first4=T.W. |title=A histopathological study of 643 cutaneous horns |journal=British Journal of Dermatology |volume=124 |issue=5 |pages=449–52 |year=1991 |pmid=2039721 |doi=10.1111/j.1365-2133.1991.tb00624.x|s2cid=73180732 }}

Signs and symptoms

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.

{{cite journal

|pmid= 2172337|year= 1990

|title= Cutaneous horn of the penis: Its association with squamous cell carcinoma and HPV-16 infection

|volume= 23|issue= 5 Pt 2|pages= 969–72

|journal= Journal of the American Academy of Dermatology

|doi= 10.1016/0190-9622(90)70315-9

|url= https://zenodo.org/record/1258417}}

File:Cornu cutaneum 2.jpg

Cause

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.{{cite journal |last1=Nthumba |first1=Peter M |title=Giant cutaneous horn in an African woman: a case report |journal=Journal of Medical Case Reports |volume=1 |page=170 |year=2007 |pmid=18053226 |pmc=2225419 |doi=10.1186/1752-1947-1-170 |doi-access=free }} As with many other wart-like skin conditions, a link to the HPV virus family, especially the HPV-2 subtype has been suggested.{{cite journal |last1=Wang |first1=W |last2=Wang |first2=C |last3=Xu |first3=S |last4=Chen |first4=C |last5=Tong |first5=X |last6=Liang |first6=Y |last7=Dong |first7=X |last8=Lei |first8=Y |last9=Zheng |first9=X |title=Detection of HPV-2 and identification of novel mutations by whole genome sequencing from biopsies of two patients with multiple cutaneous horns |journal=Journal of Clinical Virology |volume=39 |issue=1 |pages=34–42 |year=2007 |pmid=17368088 |doi=10.1016/j.jcv.2007.01.002 }}

Diagnosis

Histologically they are characterized by compact proliferation of keratin

Treatments

Treatment is surgical excision

Notable cases

Zhang Ruifang, aged 101 ({{As of|2010|lc=y}}), 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 {{convert|6|cm|round=0.5|abbr=in}} in length. Another is forming on the opposite side of her forehead.Writers, Staff. (2010-03-09) [http://www.heraldsun.com.au/news/breaking-news/chinese-woman-zhang-ruifang-aged-101-grows-devil-horn/story-e6frf7jx-1225838906659?from=public_rss Chinese woman Zhang Ruifang, aged 101, grows 'devil' horn] {{Webarchive|url=https://web.archive.org/web/20110614091911/http://www.heraldsun.com.au/news/breaking-news/chinese-woman-zhang-ruifang-aged-101-grows-devil-horn/story-e6frf7jx-1225838906659?from=public_rss |date=2011-06-14 }}. Herald Sun. Retrieved on 2010-10-27.
Liang Xiuzhen, aged 87 (as of 2015) living in Guiyan village in Ziyang City, Sichuan province, China, grew a {{convert|13|cm|abbr=off|adj=on}} pointed horn from her forehead, earning her the nickname "Unicorn Woman".{{cite news |url=https://www.mirror.co.uk/news/weird-news/unicorn-woman-set-horn-removed-6329793 |date=2015-08-27 |access-date=2015-08-27 |title='Unicorn woman' set to have 'horn' removed from head after 13cm spike stops OAP sleeping |work=Mirror Online}}
Huang Yuanfan, aged 84 (living in Ziyuan, China).{{cite web |url=http://www.allvoices.com/contributed-news/7851291-chinas-huang-yuanfan-sprouts-3inch-horn-from-head-wierd |archive-url=https://web.archive.org/web/20110222083415/http://www.allvoices.com/contributed-news/7851291-chinas-huang-yuanfan-sprouts-3inch-horn-from-head-wierd |archive-date=2011-02-22 |title=China's Huang Yuanfan Sprouts 3-Inch Horn From Head |date=January 10, 2011}}
Shyam Lal Yadav, aged 74 (living in Madhya Pradesh, India) grew a {{convert|4|in|cm|abbr=off|adj=on|order=flip}} horn after an accident, and later had it surgically removed.{{cite news |url=https://www.indiatoday.in/india/story/mp-man-grows-devil-horn-on-head-after-injury-1599016-2019-09-14 |title=74-year-old MP man grows devil's horn after injury |work=India Today |date=September 14, 2009 }}
{{lang|fr|italic=no|Madame Dimanche}} ("Widow Sunday"), a French woman living in Paris in the early 19th century, grew a {{convert|24.9|cm|abbr=off|adj=on}} 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.[http://www.corkscrew-balloon.com/misc/mutter.html The Mütter Museum]. Corkscrew-balloon.com (2003-05-26). Retrieved on 2010-10-27.

File:François Trouille, a man with a horn growing from his head. Wellcome V0007282EL.jpg|François Trouille

File:Ulisse aldrovandi, monstrorum historia, per nicola tebaldini, bologna 1642, 058 uomo cornuto.jpg|François Trouille, in the works of Ulisse Aldrovandi

File:Mary Davis, a woman with horns, aged 74. Mezzotint. Wellcome V0007048.jpg|Mary Davis, age 74, of Chester

File:Elizabeth French, a woman with horns. Aquatint. Wellcome V0007092ER.jpg|Elizabeth French of Tenterden

File:Horny tumors.jpg|Capt. Levi Becket of Atlantic City, New Jersey, 1870

References

External links

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Category:Epidermal nevi, neoplasms, and cysts