Advanced Skin Care

Cutaneous Horn Overview

A cutaneous horn, also known as cornu cutaneum, refers to a specific appearance of a skin lesion in which a cone-shaped protuberance arises on the skin caused by overgrowth of the most superficial layer of skin (epidermis). A cutaneous horn is not a particular lesion but is a reaction pattern of the skin. Approximately 40% of cutaneous horns represent precancerous lesions called actinic keratoses. Cutaneous horns may also overlie skin cancer. When overlying cancerous skin, squamous cell carcinoma is typically at the base of the cutaneous horn, but basal cell carcinoma is also possible.
Who's At Risk
Cutaneous horns most often occur in adults, usually elderly, fair-skinned individuals with a history of significant sun exposure.
Signs and Symptoms
A cutaneous horn most often occurs on sun-exposed areas and appears as a cone-shaped protuberance arising from a skin-colored to red/pink bump or flat lesion.
Self-Care Guidelines
None necessary.
When to Seek Medical Care
Seek medical evaluation if a cutaneous horn is noted. A biopsy may be needed to assess whether the lesion is benign, precancerous, or cancerous.
Treatments Your Physician May Prescribe
If the lesion is benign, no further treatment may be needed.

If the lesion is precancerous, the physician may:
Freeze the lesion with liquid nitrogen.
Use a topical chemotherapy agent, such as 5-Fluorouracil or a topical medicine that stimulates the immune system, imiquimod.
Scrape and burn (curettage and electrodesiccation) the lesion.

Bedbug Bite Signs and Symptoms

The morning after being bitten the bedbug, you may notice an itchy hive-like bump at the site of the bite mark, which will go away through the course of the day. There may or not may not be a visible bite mark in the center of the bump. After that, what start as small bruise-like areas turn into red, intensely itchy bumps on the exposed parts of the body (arms, legs, chest, and sometimes the face). There may be a clustered configuration of 3 bites in a line (commonly known as "breakfast, lunch, and dinner"). Resolution takes about 2 weeks and leaves some darkening of the skin (post-inflammatory hyperpigmentation).

You may see tell-tale signs of the bedbug's presence, such as blood stains on the sheets, flecks of bedbug dung on or around your bed, or you may smell a sweet odor that occurs when there is a large bedbug infestation. You may be able to spot a moving bedbug if you are searching at night.
Self-Care Guidelines
The management of bedbug bites includes removing the bedbug infestation and controlling the itching.

The best time to look for live bedbugs is the middle of the night, when they come out to feed. Wash all linens in hot water and dry in a hot dryer. You may also need to wash your curtains. Scrub furniture to remove eggs, and fix any cracks that may be in the furniture; you may need to take the furniture apart to do this well. Vacuum the room, including the mattress (concentrating on the seams) and any surrounding crevices. You may want to fill and seal any cracks around the room and paste down any rolling wallpaper seams. Check the adjoining rooms for bugs as well, even if the occupants don't complain of itching.

Sometimes, in cases of severe infestation, it may be best to have a licensed pest control agent inspect and eradicate the bedbugs. Be aware that some insect repellants can be toxic to children, so make sure to find out exactly what chemicals they will be using and what the chemical's risk profile is.

Diphenhydramine (Benadryl®) can be used to control the itching. A low-strength topical corticosteroid cream or ointment, such as hydrocortisone, can be purchased over the counter to help with itching.

Athlete's Foot (Tinea Pedis)

Athlete's foot (tinea pedis), also known as ringworm of the foot, is a surface (superficial) fungal infection of the skin of the foot. The most common fungal disease in humans, athlete's foot, may be passed to humans by direct contact with infected people, infected animals, contaminated objects (such as towels or locker room floors), or the soil.

Who's At Risk
Athlete's foot may occur in people of all ages, of all races, and of both sexes. However, athlete's foot is more common in males than in females. Children rarely develop athlete's foot.

Some conditions make athlete's foot more likely to occur:
Living in warm, humid climates
Using public or community pools or showers
Wearing tight, non-ventilated footwear
Sweating profusely
Having diabetes or a weak immune system
Signs and Symptoms
The most common locations for athlete's foot include:
Spaces (webs) between the toes, especially between the 4th and 5th toes and between the 3rd and 4th toes
Soles of the feet
Tops of the feet
Athlete's foot may affect one or both feet. It can look different depending on which part of the foot (or feet) is involved and which fungus (ie, dermatophyte) has caused the infection:
On the top of the foot, athlete's foot appears as a red scaly patch or patches, ranging in size from 1 to 5 cm. The border of the affected skin may be raised, with bumps, blisters, or scabs. Often, the center of the lesion has normal-appearing skin with a ring-shaped edge, leading to the descriptive but inaccurate name ringworm. (It is inaccurate because there is no worm involved.)
Between the toes (the interdigital spaces), athlete's foot may appear as inflamed, scaly, and soggy tissue. Splitting of the skin (fissures) may be present between or under the toes. This form of athlete's foot tends to be quite itchy.
On the sole of the foot (the plantar surface), athlete's foot may appear as pink-to-red skin with scales ranging from mild to widespread (diffuse).
Another type of tinea pedis infection, called bullous tinea pedis, has painful and itchy blisters on the arch (instep) and/or the ball of the foot.
The most severe form of tinea pedis infection, called ulcerative tinea pedis, appears as painful blisters, pus-filled bumps (pustules), and shallow open sores (ulcers). These lesions are especially common between the toes but may involve the entire sole. Because of the numerous breaks in the skin, lesions commonly become infected with bacteria. Ulcerative tinea pedis occurs most frequently in people with diabetes and others with weak immune systems.