Cutaneous horn

Cutaneous horn
Cutaneous horn
Classification and external resources
eMedicine article/1056568

Cutaneous horns, also known by the Latin name cornu cutaneum, are unusual keratinous skin tumors with the appearance of horns, or sometimes of wood or coral. Formally, this is a clinical diagnosis for a "conical projection above the surface of the skin."[1] They are usually small and localized, but can in very rare cases be much larger. Although often benign, they can also be malignant or premalignant.[2]



The cause of cutaneous horns is still unknown, but it is believed that exposure to radiation can trigger the condition. This is evidenced by a higher rate of cases occurring on the face and hands, areas that are often exposed to sunlight. Other cases have reported cutaneous horns arising from burn scars.[3] As with many other wart-like skin conditions, a link to the HPV virus family, especially the HPV-2 subtype has been suggested.[4]

Prominent cases

  • Zhang Ruifang, aged 101 (living in Linlou Village, Henan province, China), has grown a cutaneous horn on her forehead, resembling what those who have examined her and her family call "Devil's Horns." Notably, this growth has expanded to reach a total of 6 centimeters in length. Another is forming on the opposite side of her forehead.[5]
  • Madame Dimanche, called Widow Sunday, a French woman living in Paris in the early 19th century, grew, in six years from the age of 76, a 24.9 cm (9.8") horn from her forehead before it was successfully removed by French surgeon Br. Joseph Souberbeille (1754–1846). A wax model of her head is on display at the Mütter Museum, The College of Physicians of Philadelphia, US.[6]


The lesion at the base of the keratin mound is benign in the majority of cases. Malignancy is present in up to 20% of cases, with squamous cell carcinoma being the most common type. The incidence of squamous cell carcinoma increases to 37% when the cutaneous horn is present on the penis.[7] Tenderness at the base of the lesion is often a clue to the presence of a possible underlying squamous cell carcinoma.


As the horn is composed of keratin, the same material found in fingernails, the horn can usually be removed with a sterile razor.

However, the underlying condition will still need to be treated. Treatments vary, but they can include surgery, radiation therapy, and chemotherapy.

See also


  1. ^ Copcu, Eray; Sivrioglu, Nazan; Culhaci, Nil (2004). "Cutaneous horns: are these lesions as innocent as they seem to be?". World Journal of Surgical Oncology 2: 18. doi:10.1186/1477-7819-2-18. PMC 421749. PMID 15176977. 
  2. ^ Yu, R.C.H.; Pryce, D.W.; MacFarlane, A.W.; Stewart, T.W. (1991). "A histopathological study of 643 cutaneous horns". British Journal of Dermatology 124 (5): 449–52. doi:10.1111/j.1365-2133.1991.tb00624.x. PMID 2039721. 
  3. ^ Nthumba, Peter M (2007). "Giant cutaneous horn in an African woman: a case report". Journal of Medical Case Reports 1: 170. doi:10.1186/1752-1947-1-170. PMC 2225419. PMID 18053226. 
  4. ^ Wang, W; Wang, C; Xu, S; Chen, C; Tong, X; Liang, Y; Dong, X; Lei, Y et al. (2007). "Detection of HPV-2 and identification of novel mutations by whole genome sequencing from biopsies of two patients with multiple cutaneous horns". Journal of Clinical Virology 39 (1): 34–42. doi:10.1016/j.jcv.2007.01.002. PMID 17368088. 
  5. ^ Writers, Staff. (2010-03-09) Chinese woman Zhang Ruifang, aged 101, grows 'devil' horn. Herald Sun. Retrieved on 2010-10-27.
  6. ^ The Mütter Museum. (2003-05-26). Retrieved on 2010-10-27.
  7. ^ Solivan, GA; Smith, KJ; James, WD (1990). "Cutaneous horn of the penis: Its association with squamous cell carcinoma and HPV-16 infection". Journal of the American Academy of Dermatology 23 (5 Pt 2): 969–72. PMID 2172337. 

External links