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Solar Keratosis M011

Document
Last amended 
7 July 2015

Current RMA Instruments:

Reasonable Hypothesis SOP

73 of 2012

Balance of Probabilities SOP

74 of 2012

Changes from Previous Instruments:

SOP Bulletin 162

ICD Coding:
  • ICD-9-CM: 702.0
  • ICD-10-AM: L57.0
Brief description:

Solar keratoses are scaly or crusty spots that occur on sun-exposed areas of skin.   They are potentially pre-cancerous and may turn into squamous cell carcinomas.

Confirming the diagnosis:

The diagnosis can be made on clinical grounds, so a report from a treating medical practitioner is sufficient to confirm the diagnosis.  Histology reports may be available in some cases. 

The relevant medical specialist is a dermatologist.

Additional diagnoses covered by these SOPs
  • Actinic keratosis
Conditions not covered by these SOPs   
  • Basal cell carcinoma (skin)*    (Non melanotic malignant neoplasm of the skin)
  • Bowen’s disease*    (Non melanotic malignant neoplasm of the skin)
  • Chronic solar skin damage other than solar keratosis#   
  • Hutchinson’s melanotic freckle#                                              
  • Malignant melanoma of the skin*       
  • Seborrhoeic keratosis*
  • Solar elastosis#                                                                                
  • Squamous cell carcinoma (skin)*    (Non melanotic malignant neoplasm of the skin)

*another SOP applies - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

The clinical onset will be when a lesion, subsequently confirmed to be a solar keratosis by a medical practitioner, is first noted by an individual.   Age of onset varies with sun-exposure and skin type.  Onset may be early in adult life in some cases, but more typically it occurs in middle to later life.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.   Appropriate clinical management involves timely treatment and monitoring of the condition and advice on sun-protection measures.  A range of medical and surgical treatment options are available.   The natural history of the condition is for multiple lesions to occur and to continue to develop over time, typically becoming more numerous with time.

Further comments on diagnosis

This SOP covers solar or actinic keratosis but not other chronic solar skin damage (solar elastosis) and not non-melanotic malignant skin neoplasms.  However, a claim for non-malignant chronic solar skin damage will generally be best answered using the solar keratosis SOP.  Other forms of chronic solar skin damage have little if any clinical significance and generally do not require treatment.