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.
Sources
Based on clinical guidelines from the American Academy of Dermatology (AAD) and British Association of Dermatologists (BAD). Statistics from NCI SEER Program and IARC GLOBOCAN. Staging per AJCC Cancer Staging Manual, 8th ed. Full methodology