Claudia Florida Costea1,2*, Gabriela Dimitriu2, Anca Sava3,4, Mădălina Chihaia2, Cristina Dancă2, Andrei Cucu2, Nicoleta Dumitrescu6 and Dana Turliuc5,7
1Department of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania
2IInd Ophthalmology Clinic, “Prof. Dr. Nicolae Oblu” Emergency Hospital, Iaşi, Romania
3Pathology Laboratory, “Prof. Dr. Nicolae Oblu” Emergency Hospital, Iaşi, Romania
4Department of Anatomy, “Grigore T.Popa” University of Medicine and Pharmacy, Iaşi, Romania
5Neurosurgery Unit II, “Prof. Dr. Nicolae Oblu” Emergency Hospital of Iaşi, Romania
6 IIIrd year student, “Grigore T. Popa” University of Medicine and Pharmacy of Iaşi, Romania
7Department of Neurosurgery, “Grigore T. Popa” University of Medicine and Pharmacy of Iaşi, Romania
Received: 13 December, 2016; Accepted: 04 January, 2017; Published: 05 January, 2017
Claudia Florida Costea, Assistant, PhD, Senior Ophthalmologist, Department of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, 34 Brânduşa Street, 700374 Iasi, Romania, Tel: +40744972648; Fax: +40232–210 064; E-mail:
Costea CF, Dimitriu G, Sava A, Chihaia M, Dancă C, et al. (2017) Cutaneous Horn of the Eyelid: Anatomoclinical Implications. J Clin Res Ophthalmol 4(1): 001-005. 10.17352/2455-1414.000035
© 2017 Costea CF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Eyelid; Cutaneous horn; Surgical excision; Pathology
Cutaneous horns are relatively rare benign tumors which occur most frequently on sun exposed skin and develop on various types of underlying skin lesions: benign, premalignant and malignant. The treatment of choice consists in the surgical excision of the lesion to healthy tissue. The histopathological examination is mandatory in order to establish the nature of the lesion, on which the cutaneous horn develops. We are presenting two clinical cases of cutaneous horns of the eyelid diagnosed in a 19 and a 78 year old patient, respectively, which developed on an association of preexisting lesions: chalazion or inclusion cyst, along with moderate dysplasia of the epidermis in both cases.
The cutaneous horn (cornu cutaneum) is a circumscribed, conical and keratotic lesion, which can hide benign or malignant lesions [1-3]. The clinical diagnosis is established based on its appearance, the lesion being classified as solitary or multiple, straight, curved or twisted, white or yellow [4,5], most often located at the level of the skin on the patient’s face [4,6,7]. While the cause leading to the formation of cutaneous horns  is unknown, UV radiations are believed to be the trigger of this condition . Usually, the cutaneous horn occurs in people over the age of 50, in both genders [10-14].
The cutaneous horn can occur in any part of the body: the malar or frontal areas, dorsum of nose, neck, lips , upper eyelids [2,9,12], lower eyelid , external ear [3,16], scalp [3,4], upper limbs [3,11,17,18], chest , lower limbs  and penis .
The treatment of choice is the surgical excision of the lesion to the healthy tissue [17,20,21], followed by a histopathological examination in order to confirm the diagnosis [6, 13, 18, 22, 23], the real point of interest being not the cutaneous horn, but the underlying lesion .
The cutaneous horn can develop on benign (seborrheic keratosis, viral warts, histiocytoma, inverted follicular keratosis, verrucous epidermal nevus, moluscum contagiosum, etc), premalignant (solar keratosis, arsenical keratosis, Bowen’s disease) or malignant lesions (squamocellular carcinoma, rarely, basal cell carcinoma, renal metastatic carcinoma, granular cell tumor, sebaceous carcinoma or Kaposi’s sarcoma) [2,3,14].
We are presenting two clinical cases of cutaneous horns of the eyelid diagnosed in a 19 and a 78 year old patients, respectively, which developed on an association of preexisting lesions: chalazion and inclusion cyst, along with moderate dysplasia of the epidermis in both cases.
A 19-year-old male patient, resident in a the rural area, was admitted to the Ophthalmology Clinic for a solitary firm horn on the lower eyelid, which had gradually progressed over the course of two months. One year before, the patient noticed a focal swelling of the inferior eyelid treated empirically, on which the cone shape growth developed progressively. The patient’s medical and ocular history was not significant.
The clinical examination revealed a solitary cone shape hyperkeratotic growth mesuring 1.0/0.6 cm in size, with an inflamed nodular base, located in the middle 1/3rd of the inferior right eyelid (Figure 1). There was no regional lymphadenopathy. The clinical diagnosis was that of solitary inferior right eyelid cutaneous horn. The lesion was excised completely with local anesthesia, and the defect was closed by sliding the skin of the inferior eyelid and sutured with Vicryl (gauge 6.0).