Quote -
 You can make a Troll fbm in ZBrush or Blacksmith add it in the usual way and dial it in.

Certainly... or, you could just use the existing tools in either app very carefully (in the original D|S manual, I made a pair of horns using a couple D-Form actions).

Thing is, nobody wants to spend a zillion hours stretching half-edges around, or tweaking in a different app to do it. Hell, why do you think the character packages sell so well, with half of those being only the result of dial-spins?