eMedicine Specialties > Dermatology > Benign Neoplasms

Stucco Keratosis

Author: Raymond T Kuwahara, MD, Dermatologist, Private Practice
Coauthor(s): Ron Rasberry, MD, Chief of Dermatology, Veterans Medical Center at Memphis; Associate Professor, Department of Dermatology, University of Tennessee at Memphis
Contributor Information and Disclosures

Updated: Nov 12, 2008

Introduction

Background

Stucco keratosis was first described by Kocsard and Ofner in 1965 and later by Willoughby and Soter in 1972.1,2

Stucco keratosis is a keratotic papule that is usually found on the distal lower acral extremities of males. It seems to appear with a higher frequency in males; however, it is not inherited genetically.

Usually, multiple lesions are found; in one study, between 7 and more than 100 lesions were noted on the patients. The lesion is asymptomatic, and patients usually do not complain of having the lesions. The name stucco keratosis is derived from the "stuck on" appearance of the lesions.

Pathophysiology

Stucco keratosis appears to be produced by thickening of the epidermis. The epidermis is usually exophytic with a church spire–like appearance. The surface may be regularly distributed into folds with elongation of papillae. The stratum corneum is thickened.

Surface friction may contribute to the development of the lesions. The tumor grows outward and does not penetrate. The lesions are usually found in elderly patients.

With a nested polymerase chain reaction technique, human papillomavirus types 9, 16, 23b, DL322, and 37 were detected in a 75-year-old nonimmunosuppressed man with very extensive lesions.3 This finding requires confirmation in other patients.

Frequency

United States

The incidence of stucco keratosis is about 10% of the senior population in the United States. It predominantly occurs in elderly men.

Mortality/Morbidity

  • The lesions are benign growths similar to those of seborrheic keratosis.
  • Clinically, they may be mistaken as a melanoma.

Race

  • Stucco keratosis is found in persons of all races.
  • No reports have been noted on race as a factor in this lesion.

Sex

  • The incidence is higher in males than in females.

Age

  • Elderly people are susceptible to the disease.
  • The lesions begin to appear around age 45 years.

Clinical

History

  • Stucco keratosis is a benign lesion that is best regarded as a form of seborrheic keratosis.
  • These lesions are often seen in elderly men.
  • The lesions are asymptomatic and usually go unnoticed by both the patient and the clinician.

Physical

  • The lesion appears as a keratotic papule or plaque on the lower extremities but is sometimes found on the upper extremities, usually acrally (see Media File 1).
  • If the lesion is removed by curetting, a peripheral collarette of scale is sometimes left.

Causes

  • No known cause has been reported.
  • The epidermis is hyperplastic and usually exophytic with no dysplasia. This is similar to what is seen in seborrheic keratosis.

More on Stucco Keratosis

Overview: Stucco Keratosis
Differential Diagnoses & Workup: Stucco Keratosis
Treatment & Medication: Stucco Keratosis
Follow-up: Stucco Keratosis
Multimedia: Stucco Keratosis
References
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References

  1. Kocsard E, Carter JJ. The papillomatous keratoses. The nature and differential diagnosis of stucco keratosis. Australas J Dermatol. Aug 1971;12(2):80-8. [Medline].

  2. Willoughby C, Soter NA. Stucco keratosis. Arch Dermatol. Jun 1972;105(6):859-61. [Medline].

  3. Stockfleth E, Röwert J, Arndt R, Christophers E, Meyer T. Detection of human papillomavirus and response to topical 5% imiquimod in a case of stucco keratosis. Br J Dermatol. Oct 2000;143(4):846-50. [Medline].

  4. Kirkham N. Tumors and cysts of the epidermis. In: Lever's Histopathology of the Skin. Philadelphia, Pa: WB Saunders; 1997:693.

  5. Waisman M. Verruciform manifestations of keratosis follicularis: including a reappraisal of hard nevi (Unna). Arch Dermatol. 1960;81:1-15.

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Further Reading

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Keywords

verruca dorsimanus et pedis

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Contributor Information and Disclosures

Author

Raymond T Kuwahara, MD, Dermatologist, Private Practice
Raymond T Kuwahara, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Ron Rasberry, MD, Chief of Dermatology, Veterans Medical Center at Memphis; Associate Professor, Department of Dermatology, University of Tennessee at Memphis
Ron Rasberry, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, Arkansas Medical Society, Association of Military Surgeons of the US, Royal Society of Medicine, and Southern Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Evan R Farmer, MD, Professor of Dermatology, Johns Hopkins University School of Medicine, Clinical Professor of Pathology, Virginia Commonwealth University School of Medicine; Consulting Staff, Department of Dermatology, Johns Hopkins Hospital, VCU Health Services
Evan R Farmer, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, and International Society of Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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