Stucco keratosis is a relatively common benign skin disease. Stucco keratosis occurs more frequently in elderly men. The cause of stucco keratosis is unclear. Stucco keratosis occurs at the ends of the extremities, most often in the lower extremities, especially near the Achilles tendon, back of the foot, ankles, and gastrocnemius. Gray-white papules or small plaques are not firmly attached and easily peeled off. The epidermis is intact, generally not the symptom. The treatment of stucco keratosis is to use lubricants to soften the skin and make the keratinized scales fall off. If necessary, use laser or electrocautery treatment. Stucco keratosis is generally not serious, but it is easy to recur.
What is stucco keratosis?
Stucco keratosis, also known as hand-foot dorsal warts, is similar to seborrheic keratosis but is small and papul-like. Occurs at the ends of the extremities, mainly in the lower extremities, especially near the Achilles tendon, but also in the forearm, palm, and plantar.
The skin lesions are like dry plaster, loosely adhered to the skin surface, not firmly attached, easy to remove, but not bleeding. The diameter of the skin lesions is 1 to 5 mm, and the number is several to dozens. Occurs in the extremities, more often in the lower extremities, especially near the Achilles tendon, dorsal foot, ankle, and gastrocnemius muscle. It is also seen on the forearm and back of the hand, never invading the palms, torso, and head. Most occur in men over the age of 40, mainly in the elderly. Especially when the winter is dry, the lesions are more obvious, and there are generally no symptoms. Lubricants can be used to soften the skin lesions of stucco keratosis. 12% ammonium lactate lotion, 0.1% tretinoin cream, or 20% urea cream are also effective for external use. Laser or electrocautery can be used to treat stucco keratosis when necessary.
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Diagnosis and identification of stucco keratosis
According to the clinical manifestations, the features of skin lesions, histopathology can be diagnosed.
- Doctors make diagnoses based on the characteristics of patients’ skin lesions and the results of pathological examinations.
- Features: It occurs at the ends of the extremities, more often in the lower extremities, especially near the Achilles tendon, back of the foot, ankles, and gastrocnemius. Gray-white papules or small plaques that are not firmly attached and easy to peel off. The epidermis is intact and generally asymptomatic.
- Pathological results: It can be diagnosed by seeing hyperkeratosis of the epidermis, slightly thickening of the granular layer, thickening of the spine layer, and papilloma-like hyperplasia, forming a peak shape or a spire shape.
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Keratosis types and Differential diagnosis
1. Seborrheic keratosis
Occurs on the face, chest, back, etc., Skin lesions brown or brown-black, the surface has greasy scales or sputum, histopathological examination of the disease may have parakeratosis, pseudo-angular cysts, and basal pigmentation Can be identified with stucco keratosis.
The disease is most common in older men and exposed areas such as the face and back of the hand are more common. Histopathological examination shows that epidermal cells are atypical and mitotic figures are common and can be identified.
3. Large cell acanthoma
The disease is mild keratosis, clear border rash, usually single, occurs in the exposed site, histopathology shows that the core is large and even the mitotic figures are active, which can be distinguished from stucco keratosis.
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Causes of stucco keratosis
(1) Causes of the disease
The cause is still unknown and could be related to heat or chemical damage.
The pathogenesis is still unclear. This disease is commonly seen in Australia and may be related to exposure. Similar lesions are also seen in asphalt and tar workers.
Symptoms of stucco keratosis
Common symptoms of stucco keratosis
Skin lesions such as dry stucco. The skin lesions are like dry stucco, loose and attached to the surface of the skin, easy to remove, the lesions are 1 to 5 mm in diameter and the number is several dozen. It occurs in the lower extremities, especially around the Achilles tendon, including in the back of the foot. And the back of the hand never penetrates the palms, trunk, and head.
Clinical symptoms of stucco keratosis
The damage of stucco keratosis disease is similar to seborrheic keratosis, but it is small and papul-like. Occurs in the extremities, mainly in the lower extremities, especially in the vicinity of the Achilles tendon, back of the foot, ankle, and gastrocnemius. It can also be seen on the forearm. Its diameter is 3-10mm. It is loosely attached to the skin surface like dry plaster, and it is not firmly attached, so it is easy to scrape off, but it does not bleed. The number varies from several to hundreds. Most occur in men over the age of 40, mainly in the elderly. Especially when the winter is dry, the lesions are more obvious, and there are generally no conscious symptoms.
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Investigation of stucco keratosis
Histopathology: the epidermis is papilloma and loses keratosis, such as “chapel top”, visible mild acanthosis, but no parakeratosis and pseudo-angular cysts, thickened granular layer, flat base of the tumor, visible A mild inflammatory response around the blood vessels.
How to get rid of stucco keratosis
The etiology of this disease is not clear and may be related to heat or chemical damage. Histologically, the disease manifests itself as hyperkeratosis seborrheic keratosis. Therefore, the prevention method should be based on the etiology. When conducting chemical experiments or engaged in high-temperature workers, they should pay attention to self-protection. For example, wearing safety gloves can avoid direct chemical damage. Secondly, patients who have already suffered from this disease should be actively treated to avoid serious complications caused by the aggravation of the disease.
Stucco keratosis treatment
(1) Lubricant can be used for stucco keratosis treatment to soften skin lesions and fall off. 12% ammonium lactate lotion, 0.1% tretinoin cream or 20% urea cream are also effective for external use.
(2) There is no relevant description of the prognosis.
(Reminder: The above information is for reference only, please consult your doctor for details)
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How to care for stucco keratosis
1. The diet should be light, and foods that are easy to digest and absorb such as vegetable porridge and noodle soup are better.
2. Eat more fresh fruits and vegetables to ensure vitamin intake.
3. Give liquid or semi-liquid food, such as all kinds of porridge, rice soup, etc.
Complicated by stucco keratosis
Because stucco keratosis disease mainly causes skin damage and damage to skin integrity, skin integrity can be damaged to induce skin bacterial infection or fungal infection, usually secondary to low physical fitness, or long-term use of immunosuppressive agents and onychomycosis, etc. Patients with fungal infections, such as complicated bacterial infections, may have symptoms such as fever, skin swelling, ulceration, and purulent secretions. Severe cases can cause sepsis, so it should be brought to the attention of clinicians.
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