Cutaneous Horn on an Eyebrow

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Cutaneous horn
Horn on the eyebrow. Source: AAD

No, She’s not a Unicorn! She just happens to Have a Cutaneous Horn.

An 86 years old female clocked in with a cutaneous horn on her left eyebrow. She said the horn first surfaced 10 years ago as a small peanut-sized plaque on her eyebrow. It did not cause any itching or pain. However, it did grow in magnitude for which it had to be surgically removed in 2006. Bad thing, it resurfaced just after six months of what seemed a successful surgery. The patient was a farmer by occupation and she did not report any significant family history.

Physical Examination of the Horn

Physical examination revealed that the horn was hard and immobile apart from its gray-black color. It became more irregular and rough from its apex to the bottom. Not to mention, it had a curvy appearance with a red ulcerated base. The doctors did not find any regional lymphadenopathy and other examinations like urine examination, electrocardiogram and blood investigations etc. came out normal. A CT scan of the skull also did not show calcification or any other abnormality.

Treatment: Another Surgery

Her condition demanded another surgical treatment. Only this time, it had to be more precise to avoid any relapse. Hence, the doctors opted for a careful excision of her superficial fascia with a margin of about 0.3 cm. They then used a skin graft to replace the surgical defect.

A post-operative examination of the excised lesion dropped some interesting findings. It confirmed that the cutaneous horn (hyperkeratosis) stemmed from a squamous cell carcinoma.

Nevertheless, the patient recovered completely within just six months. She developed a permanent not-so-significant scar though. And as of now, she is doing well and gets called up for follow-up sometimes.

Post-operative view of the woman’s eyebrow

Reference

1- AAD

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