Cutaneous Horn: A Masquerade to Underlying Keratotic Basal Cell Carcinoma

Cutaneous horns are uncommon skin tumors consisting of keratotic material infrequently found on eyelids. We report the case of a 65-year-old male with a two-month history of cutaneous horn arising from the right lower eyelid. Histopathological examination following the excision biopsy disclosed a keratotic basal cell carcinoma (BCC). Basal cell carcinomas are slow-growing lesions with a history ranging from months to years. The keratotic form of basal cell carcinoma is a less common presentation of a cutaneous horn. A cutaneous horn is usually derived from an underlying lesion that may be benign, premalignant, or malignant. The diagnostic dexterity of keratotic BCC emphasizes the importance of histopathological confirmation in establishing the diagnosis and modifying management. To the best of our knowledge, this is the first case report of a keratotic basal cell carcinoma masquerading as a small cutaneous horn with such a short duration.