Soriano Livia Francine, Piansay-Soriano Miriam Emily
Department of Dermatology, Davao Doctors Hospital, Davao City, Philippines; ; Imperial College Healthcare NHS Trust, London, United Kingdom.
Department of Dermatology, Davao Doctors Hospital, Davao City, Philippines;
J Dermatol Case Rep. 2015 Dec 31;9(4):113-5. doi: 10.3315/jdcr.2015.1217.
A giant cutaneous horn (GCH) is a morphologic description of conical lesion with a dense, hyperkeratotic protrusion of more than 1 cm in height that resembles an animal horn but without its bony core. These can occur in association with benign, premalignant or malignant cutaneous diseases which can be determined by excision and histopathologic review of the base. A PubMed search (performed June 2015) revealed 54 cases of giant cutaneous horns in world literature. The most common site affected was the scalp followed by lip and leg. The commonest histological diagnosis found was squamous cell carcinoma followed by verruca vulgaris and trichilemmal horns.
We present an 85-year-old Filipino female with a one year history of a rapidly growing skin lesion on her upper chest. This was excised fully and histological review of the base demonstrated a keratoacanthoma.
This is the first known occurrence of a giant cutaneous horn on the chest. While giant cutaneous horns are more commonly associated with malignant lesions, differential diagnosis includes benign lesions such as keratoacanthomas. This differential can be considered in a rapidly growing lesion. Excision and histopathologic review of the base of a cutaneous horn are essential to guide potential further therapy.
巨大皮肤角（GCH）是一种对圆锥形病变的形态学描述，其为致密的、高度超过1厘米的角化过度性突出，形似动物角但无骨质核心。这些病变可与良性、癌前或恶性皮肤疾病相关，可通过切除及对病变基部进行组织病理学检查来确定。一项PubMed检索（于2015年6月进行）显示，世界文献中有54例巨大皮肤角病例。最常受累的部位是头皮，其次是唇部和腿部。最常见的组织学诊断是鳞状细胞癌，其次是寻常疣和毛囊角。
我们报告一名85岁的菲律宾女性，其胸部上方有一个快速生长的皮肤病变，病史为一年。该病变被完整切除，对基部的组织病理学检查显示为角化棘皮瘤。
这是已知首例发生于胸部的巨大皮肤角。虽然巨大皮肤角更常与恶性病变相关，但鉴别诊断包括角化棘皮瘤等良性病变。对于快速生长的病变可考虑这种鉴别。切除皮肤角基部并进行组织病理学检查对于指导潜在的进一步治疗至关重要。
