Bullous Disorders
Bullous disorders are a group of rare skin conditions causing large, fluid-filled blisters. This diagnostic code covers several conditions including benign chronic familial pemphigus (Hailey-Hailey), bullous pemphigoid, dermatitis herpetiformis, epidermolysis bullosa acquisita, pemphigus foliaceous, pemphigus vulgaris, and porphyria cutanea tarda. They are rated under Diagnostic Code 7815 using the General Rating Formula for the Skin. Porphyria cutanea tarda is a presumptive condition for veterans with Agent Orange exposure if diagnosed within one year of last exposure at a severity of at least 10%.
VA Rating Levels
Topical medications used at least once over a 12-month period, or lesions cover less than 5% of the total body, or less than 5% of exposed areas.
Lesions cover 5 to 19% of the total body or 5 to 19% of exposed areas, or systemic therapy was needed for less than 6 weeks total over a 12-month period.
Lesions cover 20 to 40% of the total body or 20 to 40% of exposed areas, or systemic therapy was needed for 6 weeks or more total over a 12-month period.
Lesions cover more than 40% of the total body or more than 40% of exposed areas, or constant or near-constant systemic therapy was needed over a 12-month period.
Exam Tips & Key Evidence
- →Porphyria cutanea tarda is presumptive for Agent Orange exposure if diagnosed within one year at a severity of at least 10%.
- →Bullous disorders can affect multiple organ systems. Common secondary conditions include eye problems, digestive conditions, genitourinary issues, lung conditions, and mouth conditions.
- →If blistering causes scarring, check whether a rating under the scars or disfigurement schedule would be more favorable.
- →These conditions often require immunosuppressive therapy, which qualifies as systemic therapy for a higher rating.
Commonly Related Conditions
38 CFR Reference
38 CFR $ 4.118, Diagnostic Code 7815