Cutaneous horn

Cutaneous horn Cutaneous horn is a clinical diagnosis that refers to a conical projection on the skin that is similar to a miniature horn. The base of the horn may be flat, nodular or crateriforma. Cutaneous horn is composed of compacted keratin. More histological lesions have been documented based on quantity of keratin, and histologic confirmation is often necessary to exclude malignant changes. No clinical feature to distinguish between malignant and benign lesions. The sensitivity and large favors malignant lesions.
The lesion is benign in most cases. Malignancy is present in 20% of cases, the most common type was squamous cell carcinoma. The incidence of carcinoma increases to 33% when the cutaneous horn is present on the penis. Sensitivity to the lesion is usually a sign of the possible presence of a squamous cell carcinoma. Appropriate treatment varies depending on the type of lesion. To exclude a malignant biopsy is important horn base. Neoplasms are excised. Benign lesions do not require treatment other than diagnostic biopsy. In patients with squamous cell carcinoma or basal cell carcinoma are given further consideration to follow appellant in the first three years after treatment.
Pathogenesis and causes
Horn skin rash usually appears on sun-exposed areas but may also occur on the unexposed. Resulting in the formation of hyperkeratosis develops on the surface of a horn hiperproliferative injuries. It is most commonly a benign wart or seborrheic keratosis, or may be a premalignant actinic keratoses. Over half of the croissant skin are benign, and 37% develop from actinic keratoses. Malignancy is reported to the horn in 20% of cases. Benign lesions associated with cutaneous horns include angiokeratomul, angioma, benign lichenoid keratosis, cutaneous leishmaniasis, dermatofibromul, discoid lupus, infundibulare cysts, nevus anemicus, acantomul epidermolitic, fibroids, Balan, organoid nevus, prurigo nodularis, piogenic granuloma, sebaceous adenoma, seborrheic keratosis and warts. Premalignant or malignant lesions with the potential that can give rise to a cutaneous horn include adenoacantomul, actinic keratoses, arsenic keratoses, basal cell carcinoma, Bowen's disease, Kaposi's sarcoma, malignant melanoma, Paget's disease, renal cell carcinoma, sebaceous carcinoma and squamous cell carcinoma.
Signs and symptoms
The peak incidence for cutaneous horn is to persons of 60 years. Lesions in the neoplasia to occur more often in patients over 70 years. Cutaneous horn is usually asymptomatic. Due to excessive height they can be traumatized. Trauma pain cause inflammation at the base. Rapid proliferation may also occur. Distribution of cutaneous horn usually appears on sun-exposed areas, especially on the face, nose, arms, back of hands against siureche. It is a hyperkeratotic papule with a height more than half the width of the base. Is typically a few mm in length.
Diagnosis
Diagnosis is confirmed through a biopsy. Histological examination showed keratosis can be compact or parakeratotica ortokeratotica. Is frequently associated acanthosis. The differential diagnosis is made with warts and pilomatricoma nongenitale piercing.
Treatment
Recommended treatment varies depending on the type of lesion. To exclude malignancy is essential to perform a biopsy of the horn base. In the case of benign lesions and benign biopsy is therapeutic. Aporpiate neoplasms are excised with margins. Patients with squamous cell carcinoma shows croissants should be evaluated for metastasis. Lozala destruction by cryosurgery is first-line treatment for cutaneous horn. In patients with squamous cell carcinoma or basal cell carcinoma are given further consideration to follow appellant in the first three years after treatment.