Management

If left untreated the tumour will resolve spontaneously. However, it is usual to remove the tumour because:

• it is not possible to be certain that it is not a squamous cell carcinoma
  • a study examining underlying causes of cutaneous horns found that 23% were due to either malignant or premalignant conditions
  • in light of possible risk of squamous cell carcinoma then an urgent dermatology review is required
• spontaneous resolution leaves an atrophic scar that is often cosmetically unattractive

Surgical excision provides the best specimen for histological examination and a good cosmetic result. Other standard treatment measures include curettage or cryotherapy.

Both low dose radiotherapy and intralesional 5-fluorouracil have been used successfully.

Reference:

• Mencía-Gutiérrez E, Gutiérrez-Díaz E, Redondo-Marcos I, Ricoy JR, García-Torre JP. Cutaneous horns of the eyelid: A clinicopathological study of 48 cases. J Cutan Pathol. 2004;31:539-43