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. Stucco keratosis seems to appear with a higher frequency in males; however, it is not inherited genetically.
Usually, multiple lesions are found in stucco keratosis; 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 stucco keratosis 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 stucco keratosis lesions.3 This finding requires confirmation in other patients.
Frequency
United States
The incidence of stucco keratosis is approximately 10% of the senior population in the United States. Stucco keratosis predominantly occurs in elderly men.
Mortality/Morbidity
- The lesions of stucco keratosis are benign growths similar to those of seborrheic keratosis.
- Clinically, stucco keratosis lesions 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 stucco keratosis.
Sex
- The incidence of stucco keratosis is higher in males than in females.
Age
- Elderly people are susceptible to stucco keratosis.
- The stucco keratosis 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.
- Stucco keratosis lesions are often seen in elderly men.
- The stucco keratosis lesions are asymptomatic and usually go unnoticed by both the patient and the clinician.
Physical
- Stucco keratosis lesions appear as keratotic papules or plaques on the lower extremities but are sometimes found on the upper extremities, usually acrally. Note the image below.
- If the lesion is removed by curetting, a peripheral collarette of scale is sometimes left.
Stucco keratosis in a 70-year-old male veteran. A few scattered white plaques are on the lower extremity.
Causes
- No known cause of stucco keratosis 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 |
| Next Page » |
References
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].
Willoughby C, Soter NA. Stucco keratosis. Arch Dermatol. Jun 1972;105(6):859-61. [Medline].
Stockfleth E, Rowert 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].
Waisman M. Verruciform manifestations of keratosis follicularis: including a reappraisal of hard nevi (Unna). Arch Dermatol. 1960;81:1-15.
Kirkham N. Tumors and cysts of the epidermis. In: Lever's Histopathology of the Skin. Philadelphia, Pa: WB Saunders; 1997:693.
Further Reading
Keywords
stucco keratosis, verruca dorsimanus et pedis
