These, mostly arise as such from the effect of UV radiation; idiopathic, without any explainable cause; or from infection of human papilloma virus.
These are mostly benign in nature and composed of compacted keratin. Malignancy at the base of the horn may be seen in about 20% of cases and the risk is 33% if present over penis. Those are mostly squamous cell carcinoma.
Warning signs of malignancy include; pain and pain on touch at the base, redness and presence of actinic keratosis at the base.
It should be excised with adequate margin and subjected for histopathological examination to look for the presence of malignancy. If malignancy is present has to be treated on its own merit.