History: Cutaneous horns are skin-colored, horny excrescences, 2 to 60 mm long. They most frequently occur on the face and scalp and also on the hands, penis, and eyelids. They are most often benign, being superimposed on an underlying seborrheic keratosis, verrnca vulgaris, angiokeratoma, molluscum contaglosum or trichilemmoma about 60% of the time. However, 20% to 30% may overlie premalignant keratoses and 20% may overlie SCCs or BCCs. Excisional biopsy with histologic examination of the base is necessary to determine the best therapy, which would be dictated by the diagnosis of the underlying lesion and by the apparent adequacy of removal. Biopsy of the present patient showed actinic kearatosis at the base of his cutaneous horn.