An Unusual Presentation of a Cutaneous Horn on the Volar Surface of a Finger: A Case Report of a Young Nigerian Adult
Oluwawalehinmi Samson Oni *
Department of Orthopaedics, Trauma and Plastic Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Onimisi Philip Osho
Department of Orthopaedics, Trauma and Plastic Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Suleman Efosa Umweni
Department of Orthopaedics, Trauma and Plastic Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Chukwudi Ngozi Madueke
Department of Anatomic and Forensic Pathology, School of Basic Clinical Sciences, University of Benin, Benin City, Edo State, Nigeria.
Charles Kenechukwu Asogwa
Department of Anatomic and Forensic Pathology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aim: To describe an uncommon cutaneous horn on the volar surface of a finger in a young Nigerian adult and highlight the unusual age and anatomical site.
Presentation of Case: A 29-year-old man presented with a solitary lesion over the volar aspect of the proximal interphalangeal joint of the right ring finger that had been present for 2 years. He reported no preceding trauma or surgery and no pain, itching, or bleeding. Examination showed a firm, horny lesion approximately 1 cm in length with a broad base and no basal erythema. The lesion was excised along the digital crease with a 3 mm margin, extending to just above the flexor tendon sheath. Histopathology demonstrated protuberant hyperkeratosis without appreciable parakeratosis, with mild papillomatosis, focal hypergranulosis, acanthosis, and mild perivascular lymphocytic infiltrates in the superficial dermis.
Discussion: Cutaneous horns are more commonly reported in older individuals and at sun-exposed sites, whereas this lesion occurred at a relatively photoprotected volar digital site in a young adult of African descent. As the horn represents a morphological presentation rather than the underlying pathology, assessment of the lesion base remains important.
Conclusion: Cutaneous horns may occur at unusual anatomical sites and in younger patients. Further documentation may help clarify their clinical spectrum in African populations.
Keywords: Cutaneous horn, volar surface of the finger, unusual presentation.