Stucco Keratosis Workup

Author: Raymond T Kuwahara, MD, MBA; Chief Editor: Dirk M Elston, MD more...

Updated: Mar 28, 2012

What would you like to print?

Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Show All

Multimedia Library

References

Laboratory Studies

No laboratory studies are required in stucco keratosis.

Imaging Studies

No imaging studies are required in stucco keratosis.

Procedures

Different methods or a combination of methods can be used to remove the stucco keratosis lesions. The most common methods in practice are liquid nitrogen therapy and curettage.

Liquid nitrogen therapy in stucco keratosis
- Lesions can be frozen with liquid nitrogen by either the spray method or the dipstick method. Because the lesions are benign, the required temperature of the lesion should reach -25°C.
- Depending on the thickness of the lesion, 2 freeze cycles of 3-10 seconds are usually required. The lesions fall off in a few days, and, if the procedure is not successful, liquid nitrogen therapy may be repeated. Ambient temperature and skin temperature as well as underlying vascularity must be taken into account. Ulceration can occur if cryotherapy is too vigorous.
Curettage in stucco keratosis
- Stucco keratosis can be removed by curettage. Lesions can be removed by gentle scraping.
- Once the lesion is removed, a topical antibiotic can be applied.
Other methods used in stucco keratosis
- The lesion can be removed by using an electrodesiccator.
- Shave removal is performed only if the lesion appears malignant, does not scrape off, or requires a definitive diagnosis.

Histologic Findings

A church spire–like epidermal hyperplasia similar to that in hyperkeratotic seborrheic keratosis is seen, as in the image below.

Photomicrograph of characteristic church spires of stucco keratosis.

Proceed to Treatment & Management

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 Health Sciences Center, Paul L Foster 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-New Jersey Medical School

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, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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.

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.

View Table List

Read more about Stucco Keratosis on Medscape