Current RMA Instruments
| Reasonable Hypothesis SOP | 79 of 2021 |
| Balance of Probabilities SOP | 80 of 2021 |
Changes from previous Instruments
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. A report from a treating general practitioner or dermatologist is sufficient to confirm the diagnosis. Histology reports may be available in some cases.
Additional diagnoses covered by these SOPs
- Actinic keratosis
- Multiple keratosis lesions in an area of chronic actinic skin damage, AKA "field cancerisation". In this setting areas of photodamaged skin adjacent to solar keratoses are covered by the SOP. Skin cancers in the same area are covered by separate SOPs.
Conditions not covered by these SOPs
- arsenical keratoses
- Basal cell carcinoma (skin)* (non-melanotic malignant neoplasm of the skin SOP)
- Bowen’s disease* (non-melanotic malignant neoplasm of the skin SOP)
- Hutchinson’s melanotic freckle#
- Malignant melanoma of the skin*
- Seborrhoeic keratosis*
- Solar elastosis (in the absence of solar keratosis)#
- Squamous cell carcinoma (skin)* (non-melanotic malignant neoplasm of the skin SOP)
*another SOP applies
# 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.