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.
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. This finding requires confirmation in other patients.
The incidence of stucco keratosis is approximately 10% of the senior population in the United States. Stucco keratosis predominantly occurs in elderly men.
No laboratory studies are required in stucco keratosis.
No imaging studies are required in stucco keratosis.
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.
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.
Stucco keratosis is a benign lesion that can be removed by curettage or cryotherapy. No other medical care is required.
No surgical care is required in stucco keratosis.
No medical therapy is required in stucco keratosis.
Patients with stucco keratosis should be advised to have a periodic skin examination.