|Year : 1997 | Volume
| Issue : 6 | Page : 366-367
Cutaneous horn overlying psoriasis
SR Sengupta, Koushik Lahiri, PK Gupta
S R Sengupta
Source of Support: None, Conflict of Interest: None
A 32-year old man presented with erythematous papulosquamous lesions on the body with multiple horns of varying size and shape on scalp.
Keywords: Psoriasis, Cutaneous horn
|How to cite this article:|
Sengupta S R, Lahiri K, Gupta P K. Cutaneous horn overlying psoriasis. Indian J Dermatol Venereol Leprol 1997;63:366-7
Cutaneous horn is a clinical condition characterized by horny out-growth of otherwise normal epidermis caused by increased adhesiveness of keratinised material. It has been noticed on top of many clinical conditions of diverse aetiology like actinic keratoses, wart, molluscum contagiosum, seborrheic keratoses, naevus and keratoacanthoma, basal cell and squamous cell carcinoma. Penile horn, giant palmar cornu cutaneum, cutaneous horn in lichen planus and follicular infundibulum tumour have also been reported. We report a patient who developed cutaneous horns over the plaques of psoriasis of the scalp.
| Case Report|| |
A 45-year-old male developed multiple horny projections of varying size on scalp for the last one year. It started insidiously as a solitary projection on top of perceptable papulosquamous lesion on the scalp. Gradually it increased to about twelve in number and attained a maximum size upto 5 cm in length [Figure - 1]. A solitary lesion, over right side of his scalp, fell off spontaneously whereas the others continued to persist till intervention. All the lesions were nonindurated, nontender and non infected with no sign of bleeding and ulceration. Gradually multiple erythematous scaly plaques appeared on his scalp, axilla, chest and genitalia for the last 6 months. The nails and mucous membrane of mouth and genitalia were spared. There was no arthropathy. Auspitz's sign was demonstrable on the skin lesions. The routine investigations which included complete haemogram, blood sugar, uric acid, and x-ray chest were within normal limits. The histologic findings from a lesion on skin was suggestive of psoriasis. Cutting of hair along with application of salicylic acid paste on cornu helped to resolve the lesions within 2 weeks.
| Discussion|| |
Cutaneous horn is a conical markedly hyperkeratotic excrescence or overgrowth of epidermis caused by many diseases like naevus,  keratoacanthoma, wart,  and solar keratosis.  Squamous cell carcinoma, basal cell epithelioma or marsupialized trichilemmal cyst,  in rare instances, also have shown to develop this condition. Cornucutaneum has also been described to occur in single or multiple numbers over glans penis.  Inflammation and induration beneath the horn is suggestive of malignant transformation. In our case it developed on top of psoriasic plaques. It responded very well and completely resolved with acid salicylic paste and did not recur. This kind of cornuate projection may be considered as a kind of morphologic variants of tinea amiantacea which can often be noticed in psoriasis. But they are often found over occiput in a child and the presence of cutaneous horn over such patches of pityriasis or tinea amiantacea is not usually expected.
| References|| |
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|3.||Brownstein M H, Shapiro E E. Trichilemmal horn: Cutaneous horn overlying trichilemmoma. Clin Exp Dermatol 1979; 4: 59-63. |
|4.||Ayyangar M C. Cornu cutaneum genitales. Ind J Dermatol Venereol Leprol 1987; 53: 118. |
[Figure - 1]