Cutaneous Horn
Also known as: Cornu Cutaneum
Hard cone-shaped keratin projection. The horn is harmless - but 16% hide cancer at the base.
What to look for
Side-by-side comparison
Normal skin
Flat surface
Cutaneous horn
Hard cone-shaped projection
A cutaneous horn is a hard, conical keratin projection from the skin surface. It can range from millimeters to several centimeters. The horn itself is just keratin - the critical question is what lies at the base.
Approximately 60% arise from benign conditions, 23% from precancerous lesions (AK), and 16% from malignant lesions (SCC). Features suggesting malignancy: sun-exposed location, base wider than the horn, tenderness, surrounding redness, older age.
All cutaneous horns require biopsy of the base - not just removal of the horn.
Quick self-check
Does this look like cutaneous horn? Answer 2 questions.
Is there a hard horn-like projection sticking up from the skin?
Is it on a sun-exposed area like face or ears?
Risk factors
- Chronic sun exposure
- Fair skin
- Age over 60
- Immunosuppression
When to see a dermatologist
- ⚠Any hard horn-like projection from the skin
- ⚠Especially on sun-exposed face or ears
- ⚠If the base appears red, tender, or wider than the horn
Often confused with
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Full ABCDE check →Frequently asked questions
Is a cutaneous horn cancer?
The horn itself is just keratin. But about 16% have cancer (usually SCC) at the base, and 23% have precancer (usually AK). The base must always be biopsied.
Can I cut it off at home?
No. Removing only the horn without evaluating the base can miss underlying cancer. A dermatologist must excise horn and base together for pathology.