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Cutaneous horns of the eyelid: a clinicopathological study of 48 cases
Enrique Mencía-Gutiérrez1, Esperanza Gutiérrez-Díaz, Irene Redondo-Marcos
1Department of Ophthalmology, 12 de Octubre Hospital, Complutense University, Cedro 23, E28250 Torrelodones, Madrid, Spain. emencia.hdoc@salud.madrid.org
Insights
Cutaneous horns are keratinous skin growths often found on elderly men. While typically benign, their underlying pathology, ranging from seborrheic keratosis to skin cancer, requires careful evaluation.
Area of Science:
- Dermatology
- Ophthalmology
- Pathology
Background:
- Cutaneous horn (cornu cutaneum) is a keratinous skin lesion resembling an animal horn.
- It arises from abnormal keratinization of superficial or deep skin layers.
- This lesion can obscure underlying benign, premalignant, or malignant conditions.
Purpose of the Study:
- To analyze the histopathological findings of eyelid cutaneous horns.
- To determine the prevalence of associated pathologies in cutaneous horn cases.
Main Methods:
- Retrospective analysis of 48 eyelid cutaneous horn cases treated between 1992 and 2002.
- Surgical treatment was the primary intervention.
Main Results:
- The study included 43 patients (24 men, 19 women) with a mean age of 62.
- Histological analysis revealed: 77.1% benign (seborrheic keratosis most common), 14.6% premalignant (actinic keratosis), and 8.3% malignant (basal cell carcinoma, squamous cell carcinoma).
Conclusions:
- Cutaneous horns predominantly affect elderly men and occur on sun-exposed areas.
- The clinical significance lies in identifying the underlying pathology, as the horn itself is inert keratin.
- While usually benign, associated premalignant and malignant lesions necessitate thorough histopathological examination.
Background:
Cutaneous horn (cornu cutaneum) is a morphological designation for a protuberant mass of keratin that resembles the horn of an animal. It results from unusual cohesiveness of keratinized material from the superficial layers of the skin or implanted deeply in the cutis. This lesion may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous conditions.
Methods:
A retrospective analysis of 48 cases of cutaneous horns of the eyelid treated between 1992 and 2002 has been performed.
Results:
Twenty-four men and 19 women, with a mean age of 62 years (range 16-90), were treated by surgery. Histologically, 77.1% were associated with benign specimens at the base pathology, 14.6% were premalignant, and finally, 8.3% were caused by malignant skin tumors. The most common lesion was seborrheic keratosis among the benign lesions, actinic keratosis among the premalignant ones, and basal cell carcinoma and squamous cell carcinoma among the malignant ones.
Conclusion:
Cutaneous horns usually appear on exposed skin areas in elderly men. The important issue in this condition is not the horn itself, which is just dead keratin, but rather the nature of the underlying disease, although the horns are usually benign.
