TOC and Sample Chapters - McGraw-Hill Professional
TOC and Sample Chapters - McGraw-Hill Professional
TOC and Sample Chapters - McGraw-Hill Professional
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Section 11 Precancerous Lesions <strong>and</strong> Cutaneous Carcinomas 227<br />
Figure 11-1. Solar keratoses <strong>and</strong> invasive squamous cell carcinoma Multiple, tightly adherent dirty looking<br />
solar keratoses (see also Figs. 10-25 to 10-27). The large nodule shown here is covered by hyperkeratoses <strong>and</strong> hemorrhagic<br />
crusts; it is partially eroded <strong>and</strong> firm. This nodule is invasive squamous cell carcinoma. The image is shown to<br />
demonstrate the transition from precancerous lesions to frank carcinoma.<br />
Cutaneous Horn ICD-9: 702.2 ° ICD-10: L85.8<br />
■ A cutaneous horn (CH) is a clinical entity having<br />
the appearance of an animal horn with a papular<br />
or nodular base <strong>and</strong> a keratotic cap of various<br />
shapes <strong>and</strong> lengths (Fig. 11-2).<br />
■ CHs most commonly represent hypertrophic solar<br />
keratoses. Non-precancerous CH formation can<br />
also occur in seborrheic keratoses <strong>and</strong> warts.<br />
■ CHs usually arise within areas of dermatoheliosis<br />
on the face, ear, dorsum of h<strong>and</strong>s, or forearms,<br />
<strong>and</strong> shins.<br />
◧ ◐<br />
■ Clinically, CHs vary in size from a few millimeters<br />
to several centimeters (Fig. 11-2). The horn may<br />
be white, black, or yellowish in color <strong>and</strong> straight,<br />
curved, or spiral in shape.<br />
■ Histologically, there is usually hypertrophic actinic<br />
keratosis, SCCIS, or invasive SCC at the base.<br />
Because of the possibility of invasive SCC, a CH<br />
should always be excised.