Cutaneous horn is a relatively uncommon lesion consisting of keratotic material resembling that of an animal horn. This kind of lesion is more common in Caucasians and in older age groups. The primary lesion underlying the horny material may be benign, premalignant or malignant. The treatment of choice is an excisional biopsy with a narrow margin, because of the possibility of malignancy. The material must be submitted for histopathological evaluation. The first reported case of cutaneous horn arising on the vermillion border of the lower lip in a black child is presented.