skip to main content

Cutaneous Horn — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSkin CancerCutaneous HornSCE Dermatology

A 60-year-old man has a cutaneous horn on his forehead. The horn is 15 mm long arising from an erythematous indurated base. What is a cutaneous horn and what must be excluded?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — A cutaneous horn is a clinical morphological description (not a diagnosis) — it is a conical projection of compact keratin; the base must be biopsied to exclude SCC, which underlies approximately 15-20% of cutaneous horns

A cutaneous horn (cornu cutaneum) is a clinical morphological description — a conical projection of compact keratin arising from the skin surface. It is NOT a histological diagnosis. The critical clinical question is what lies at the base. Cutaneous horns can arise from benign (seborrhoeic keratosis, wart, actinic keratosis) or malignant (SCC, BCC) conditions. Approximately 15-20% have SCC at the base. Features suggesting malignancy at the base include: induration, erythema, tenderness, rapid growth, location on sun-damaged skin, and patient age >60. ALL cutaneous horns should be excised with the base intact for histological examination. Shaving or avulsing the horn without examining the base risks missing underlying malignancy.

Reference: BAD 2020 SCC; DermNet NZ