Pediatric Eyelid Cutaneous Horns: A Case Series and Literature Review

Purpose: To describe the clinical and histopathologic features of pediatric eyelid cutaneous horns.

Design: Retrospective observational case series and review of literature.

Subjects: Five pediatric patients with eyelid cutaneous horns.

Methods: Five cases with eyelid cutaneous horns were retrospectively identified using departmental databases. Patients' records were analyzed for demographic data, clinical appearance, histologic findings, and clinical course. An excisional biopsy of the lesion was performed in 3 patients. The remaining 2 patients were managed conservatively.

Main outcome measures: Clinical outcome and histopathologic evaluation with emphasis on excluding malignancy.

Results: All 5 cutaneous horn lesions resolved surgically or conservatively. The average age at presentation was 6.6 years (range 5-11 years). Clinically, 4 lesions were preceded by a hordeolum or chalazion and all excised lesions had benign features on histologic examination. Mitotic figures or atypia were not observed. None of the patients developed recurrence during the follow-up period ranging from 1 to 96 months. Five previous reports of five cases were found on review of the literature. Our case series doubles this number to support the benign nature of these lesions in children.

Conclusions: Pediatric eyelid cutaneous horns are closely related to eyelid margin inflammatory disease and appear to follow a benign course. This contrasts with the adult population where cutaneous horns are frequently associated with neoplasia.