Erythroderma
Erythroderma refers to intense and usually widespread reddening of the skin due to inflammatory skin disease. It is rated under Diagnostic Code 7817 based on the level of systemic treatment used and whether treatment has failed. This condition is commonly secondary to another skin condition, so if the symptoms are already accounted for under another rating schedule, they cannot also be used to produce a rating under this one. Treatment failure is defined as either disease progression or less than a 25% reduction in the extent and severity of disease after 4 weeks of prescribed therapy, as documented in medical records.
VA Rating Levels
Topical treatments are used over the past 12 months.
For a total of less than 6 weeks over the past 12 months, systemic therapy such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB treatments, biologics, or electron beam therapy was needed.
For a total of 6 weeks or more over the past 12 months, systemic therapy such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB treatments, biologics, or electron beam therapy was needed.
No current treatment due to a documented history of treatment failure with one treatment regimen.
Most of the skin is affected along with symptoms such as weight loss, fever, or low protein levels in the blood, AND one of the following applies: no current treatment due to documented treatment failure with two or more treatment regimens, or constant or near-constant systemic therapy was required over the past 12 months.
Exam Tips & Key Evidence
- →Treatment failure is specifically defined as disease progression or less than 25% improvement after 4 weeks of prescribed therapy. Keep detailed records of treatment outcomes.
- →Since erythroderma is often secondary to another skin condition, be mindful of pyramiding rules. You cannot use the same symptoms for two separate ratings.
- →The 60% rating is unique because it is for having NO current treatment due to documented treatment failure, not for ongoing treatment.
- →This is one of the few skin conditions that can be rated at 100% on the schedular basis.
Commonly Related Conditions
38 CFR Reference
38 CFR $ 4.118, Diagnostic Code 7817