Stucco Keratosis

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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.

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. On microscopic examination, 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 into the dermis. 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.

Various genetic mutations, including PIK3CA and FGFR3 have been reported in common seborrheic keratoses. ^[4] A 2010 study demonstrated that three of five stucco keratosis samples revealed a PIK3CA mutation, but not the FGFR3 mutation. ^[5] Further study will likely highlight the genetic background for stucco keratoses.

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

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

The incidence of stucco keratosis is higher in males than in females.

Elderly people are susceptible to stucco keratosis. The stucco keratosis lesions begin to appear around age 45 years.

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

Patients with stucco keratosis can be informed that the lesions are not cancerous. Because lesions are found in elderly patients, the patients can be taught the “ABCDEs” of melanoma.

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

Willoughby C, Soter NA. Stucco keratosis. Arch Dermatol. 1972 Jun. 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. 2000 Oct. 143(4):846-50. [Medline].

Heidenreich B, Denisova E, Rachakonda S, Sanmartin O, Dereani T, Hosen I, et al. Genetic alterations in seborrheic keratoses. Oncotarget. 2017 Mar 30. [Medline]. [Full Text].

Hafner C, Landthaler M, Mentzel T, Vogt T. FGFR3 and PIK3CA mutations in stucco keratosis and dermatosis papulosa nigra. Br J Dermatol. 2010 Mar. 162(3):508-12. [Medline].

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

Errichetti E, Stinco G. Dermoscopy in General Dermatology: A Practical Overview. Dermatol Ther (Heidelb). 2016 Sep 9. [Medline].

Sezer E, Özturk Durmaz E, Çetin E, Şahin S. Meyerson Phenomenon as a Component of Melanoma in situ. Acta Dermatovenerol Croat. 2016 Apr. 24 (1):81-2. [Medline].

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

Katherine H Fiala, MD Clinical Associate Professor, Department of Dermatology, Baylor Scott and White Health, Texas A&M University College of Medicine

Katherine H Fiala, MD is a member of the following medical societies: American Academy of Dermatology, American Society for MOHS Surgery, Association of Professors of Dermatology

Disclosure: Nothing to disclose.

Christopher Moreno Texas A&M Health Science Center College of Medicine

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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Raymond T Kuwahara, MD, MBA Dermatologist

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

Disclosure: Nothing to disclose.

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.

Stucco Keratosis

Research & References of Stucco Keratosis|A&C Accounting And Tax Services
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