A squamous papilloma is identified at the base of the lesion. There is no evidence of epithelial dysplasia. Name three entities in the differential diagnosis. Cutaneous horns can be produced by several underlying lesions including actinic keratosis, squamous papilloma, verrucas papilloma, seborrheic keratosis, squamous cell carcinoma, trichilemmoma, or basal cell epithelioma. When produced by benign underlying processes, these lesions may autoamputate.
Treatment requires excisional biopsy to exclude malignant etiology.
Cutaneous horns are well-circumscribed and may be easily excised at the base. Chemical ablation using bi- or trichloracetic acid is often successful in destroying the lesions, though this method does not allow for histologic evaluation. Recurrence depends on underlying etiology. Recurrences should be examined especially closely. All rights reserved.