Stucco Keratosis 

  • Author: Raymond T Kuwahara, MD, MBA; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 2, 2010
 

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.

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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.

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Epidemiology

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.
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Contributor Information and Disclosures
Author

Raymond T Kuwahara, MD, MBA  Dermatologist, Sharp Rees-Stealy Medical Group

Raymond T Kuwahara, MD, MBA is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Ron Rasberry, MD  Associate Professor, Department of Dermatology, University of Tennessee Health Science Center College of Medicine; Chief of Dermatology, Veterans Affairs Medical Center 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.

Specialty Editor Board

Evan R Farmer, MD  Clinical Professor of Pathology and Dermatology, Department of Pathology, Virginia Commonwealth University School of Medicine

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.

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.

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.

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 Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

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.

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, 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].

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

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

 
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Stucco keratosis in a 70-year-old male veteran. A few scattered white plaques are on the lower extremity.
Photomicrograph of characteristic church spires of stucco keratosis.
 
 
 
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