Stucco keratosis

A stucco keratosis was first described by Kocsard and Ofner in 1965. It is a benign keratotic papule that is usually found on the distal aspects of the lower limbs.

This chapter is set out as follows:                                

• The exact cause is unknown. Most patients report a history of prolonged or severe solar exposure but the relationship of this to the development of the lesions is uncertain. Surface friction may contribute to the development of the lesions.

• More common in men than women
• Usually found in patients aged over 40 years
• Asymptomatic

Distribution

• Lesions are numerous
• Mainly the lower legs. Also the forearms / dorsal hands

Morphology

• Size - 1 to 10 mm in diameter
• Colour - white / grey
• Macular lesions with a ‘stuck-on’ appearance
• Dry / rough surface
• Easily removed and do not bleed when come away

Step 1: reassurance

• Lesions are benign and so no specific treatment is needed

Step 2: general measures

• Provide a patient information leaflet on UV protection
• Urea-containing emollients, eg Calmurid ® cream, may help 

Step 3: physical treatments

• Are best avoided if possible
• Cryotherapy has been used, but on the lower legs it can cause ulceration