Purpose:
Cutaneous horn is a horn-like, hard conical projection that is present on the skin. We analysised all the cutaneous horn cases from 2004/12 to 2022/07 in E-Da hospital, and to recognize whether it is malignancy or not.

Materials and Methods:
It is a retrospective study. We searched the pathology database in E-Da hospital using the term “cutaneous horn” from 2004/12 to 2022/07. All the data of the patients included demographics, the sites of the lesion, diagnosis and treatment ways were collected.

Results:
We had 25 patients with different sizes cutaneous horn over different positions. The ratio of male and female is 11:14. The mean age is 70.52 years old (range: 27~95; median age: 75). The most locations of the lesions are on the face (84%), then trunk (8%) and limbs (8%).
There are 4 malignant cases (16%), including 2 basal cell carcinomas, 1 squamous cell carcinoma and 1 keratocanthoma, and 6 actinic keratosis cases (24%) which are regarded as pre-malignancy lesions. The other cases include 8 hyperkeratosis (32%), 5 verrucous lesions (20%) and 2 fungal infections (8%). The average volume is 1.8 x 1.2 x 0.8 cm3.

Conclusions:
The location of cutaneous horn is on the face mostly. It may related to sun exposure. The malignancy or pre-malignancy potential of cutaneous horn is high (40%) in our experience. We suggest excising the lesion, and wide excision is necessary if the malignancy is confirmed.

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