CLINICOPATHOLOGICAL EVALUATION OF CUTANEOUS HORNS AT UNUSUAL ANATOMICAL SITES: AN EIGHT-PATIENT CASE SERIES FROM A TERTIARY CARE CENTRE IN EASTERN INDIA

Abstract

Background: Cutaneous horn is a conical projection of compact keratin that may arise from benign, premalignant, or malignant epidermal pathology. Because clinical morphology alone cannot reliably identify the underlying lesion, histopathological evaluation is essential. Regional data on cutaneous horns presenting at unusual anatomical sites in Eastern India remain limited. Objective: To describe the demographic profile, anatomical distribution, surgical management, histopathological findings, and postoperative outcomes of patients presenting with cutaneous horns at a tertiary care centre in Eastern India. Methods: This observational descriptive case series included eight consecutive patients with clinically diagnosed cutaneous horn lesions who underwent excision biopsy in the Department of General Surgery, Deben Mahata Government Medical College and Hospital, between 1 January 2024 and 31 December 2024. Demographic details, occupation, socioeconomic status, lesion site, duration, treatment, histopathology, and postoperative outcome were summarized descriptively. Results: The series included six males and two females, with a mean age of 49.6 +/- 14.3 years (range, 35-75 years). Seven patients belonged to a low socioeconomic background and one to a low/lower-middle socioeconomic background. Lesions involved the head and neck region in four patients, trunk in three, and hand in one. The mean duration of pathology was 21.4 +/- 10.2 months (range, 8-42 months). All patients underwent day-care excision biopsy under local anaesthesia, and the postoperative course was uneventful. Histopathological examination showed orthokeratotic hyperkeratosis in five cases, seborrheic keratosis in two cases, and trichilemmal keratinization in one case; all lesions were benign. Conclusion: In this small single-centre case series, cutaneous horns at unusual sites occurred predominantly among patients from low socioeconomic backgrounds and were histopathologically benign. Nevertheless, the known malignant potential of cutaneous horn bases supports complete excision biopsy and mandatory histopathological assessment in all cases.