Cutaneous horn of the auricle

An 81-year-old man came to the ENT Department of the University Hospital in Ioannina Greece with a large cutaneous horn of the right auricle. The horn was almost 4.5 cm long, skin colored, and had a thick, reddened base and two antler-like projections (Fig. 1). Fig. 1. Cutaneous horn of the auricle. The lesion had first appeared on the upper part of the helix of the right auricle when the patient was 60 years old. Although originally resembling an animal horn in miniature, it had gradually grown to its current dimensions. Clinical examination revealed a hard, yellowish-brown excrescence, with two opposite antler-like projections, curved with circumferential ridges, and surrounded by a somewhat acanthotic collarette, 4.5 cm and 2.5 cm in height (Fig. 1). The horn together with its base was surgically excised with the patient under local anesthesia, and the skin defect was reconstructed with a local skin flap. Histologic examination of the specimen revealed parakeratotic keratin masses consisting of an extensively thickened epidermis with atypical cells. No invasion of squamous cells into the dermis was seen. The auricle is almost normal 2 years after the patient’s initial treatment.