An Unusual Presentation of a Cutaneous Horn on the Volar Surface of a Finger: A Case Report of a Young Nigerian Adult

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.