Acquired digital fibrokeratoma is a rare, benign tumor that mostly occurs on the fingers and toes and may appear to be a supernumerary rudimentary digit. It generally affects adult men and appears as a dome-shaped papule although it can also be elongated or pedunculated. Trauma is believed to be a triggering factor in some cases. We report a male patient with an acquired digital fibrokeratoma on a finger, shaped like a cutaneous horn, and a history of minimal repeated trauma and spontaneous remissions not previously described in the literature.

A cutaneous horn is a rare, hyperkeratotic, projecting lesion that can be mostly found in sun-exposed areas of the skin. The base of the lesions can reveal an underlying malignancy. They can also be associated with several benign or pre-malignant dermatologic conditions. A biopsy of the base of the lesion and histopathological analysis are needed to confirm the diagnosis. Management depends on the underlying disease; however, surgical excision is the preferred treatment method.

A cutaneous horn is a yellow or white-colored conical projection made up of complex keratin that arises from the surface of the skin. It is usually diagnosed clinically but requires histologic examination to rule out malignancy or determine the underlying lesion. Verruca vulgaris, a human papillomavirus-associated lesion, is a very common benign underlying lesion. We present a case of an 80-year-old female who presented with a cutaneous horn on a unique location, the proximal interphalangeal joint (PIP) of her left fourth digit. Post-excision biopsy revealed a diagnosis of a verruca vulgaris-associated cutaneous horn.

Cutaneous horns are uncommon skin tumors consisting of keratotic material infrequently found on eyelids. We report the case of a 65-year-old male with a two-month history of cutaneous horn arising from the right lower eyelid. Histopathological examination following the excision biopsy disclosed a keratotic basal cell carcinoma (BCC). Basal cell carcinomas are slow-growing lesions with a history ranging from months to years. The keratotic form of basal cell carcinoma is a less common presentation of a cutaneous horn. A cutaneous horn is usually derived from an underlying lesion that may be benign, premalignant, or malignant. The diagnostic dexterity of keratotic BCC emphasizes the importance of histopathological confirmation in establishing the diagnosis and modifying management. To the best of our knowledge, this is the first case report of a keratotic basal cell carcinoma masquerading as a small cutaneous horn with such a short duration.

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Cutaneous horn is a protuberance constituted by compact keratinous material, with a hard consistence similar to a horn, which occurs more frequently in photoexposed areas. The authors describe a case of cutaneous horn on the glans considered a rare location. Verrucous carcinoma was the histopathological diagnosis of the base of the horn and lichen sclerosis, the precursor lesion.

We study a patient with the human papilloma virus (HPV)-2-driven \"tree-man\" phenotype and two relatives with unusually severe HPV4-driven warts. The giant horns form an HPV-2-driven multifocal benign epithelial tumor overexpressing viral oncogenes in the epidermis basal layer. The patients are unexpectedly homozygous for a private CD28 variant. They have no detectable CD28 on their T cells, with the exception of a small contingent of revertant memory CD4+ T cells. T cell development is barely affected, and T cells respond to CD3 and CD2, but not CD28, costimulation. Although the patients do not display HPV-2- and HPV-4-reactive CD4+ T cells in vitro, they make antibodies specific for both viruses in vivo. CD28-deficient mice are susceptible to cutaneous infections with the mouse papillomavirus MmuPV1. The control of HPV-2 and HPV-4 in keratinocytes is dependent on the T cell CD28 co-activation pathway. Surprisingly, human CD28-dependent T cell responses are largely redundant for protective immunity.

BACKGROUND: Cutaneous horns are nodules composed of compact keratin that project above the surface of the skin. The purpose of this work is to show the danger that can constitute the cutaneous horns.
UNASSIGNED: In this paper, the authors report series of three cases of facial cutaneous horns, which were respectively diagnosed as trichilemmal horn in a 79-years old patient, a cutaneous horn underlying epidermoid carcinoma in a 59-years old patient, and a basal cell carcinoma in an 80-years old patient. All patients were treated by surgical excision.
CONCLUSIONS: Cutaneous horns are generally asymptomatic and generate above all cosmetic disorders placing the patient in great social discomfort, thus prompting him to seek medical advice.
CONCLUSIONS: They emphasize the need for careful management of these lesions because of the high incidence of malignant histology.

We present a case of a man with a giant cutaneous horn over his frontal region. This case has been presented for the size of the lesion, due to delayed treatment, and to illustrate the reasons why the growth of this lesion has been possible in a western country, in the 21st century. It was a solitary, not painful lesion which caused significant aesthetic problems. The diagnosis was based on an ultrasonographic study and the treatment of choice was a surgical excision. This case is an opportunity to review the literature about the cutaneous horns, to talk about the main causes of delayed diagnosis and treatment of cutaneous lesions and, to define the role of the specialist in the assessment of emotions and patient support.