Skin Overview (38 CFR 4.118)

The skin is a large, heavy, complex organ consisting of millions of specialized cells associated with many vital functions and constituting about 15% of body weight it is also known as the integumentary system. The skin, hair, nails and glands are units of the integumentary system.

The basic overall functions of the skin are to hold the body together and to protect inner organs, bones, muscles and blood vessels. Specific functions of the skin include: protection against trauma, injurious substances, invasion of microorganisms and excessive loss of fluid and electrolytes; regulation of body temperature and blood pressure; reception of sensory stimuli; synthesis of Vitamin D; and excretion of sweat.

The skin is composed of three layers; the epidermis, dermis and subcutaneous tissue.

The top layer of skin is the epidermis. The epidermis varies in thickness, dependent upon the area of the body covered. For example, the epidermis is thin on the eyelids and many times thicker on the palms and soles of the feet. The epidermis supports blood vessels, lymph vessels, nerves and the appendages of the skin (hair, nails, and glands).

The layer beneath and cemented to the epidermis is known as the dermis. The dermis constitutes the principle mass of the skin. Blood vessels, nerves, lymphatic vessels, hair follicles, involuntary muscles and sebaceous and sweat glands are found in the dermis.

The subcutaneous layer consists largely of fat. It attaches the skin to underlying muscle and bone, and blood vessels and nerves supplying the skin run through this layer. This layer serves to support, nourish, insulate, and cushion the skin.




  • Per 38 CFR 4.118

    • For the purposes of this section, systemic therapy is treatment that is administered through any route (orally, injection, suppository, intranasally) other than skin. For the purposes of this section, topical therapy is treatment administered through the skin.

    • Two or more skin conditions may be combined in accordance with ยง4.25 only if separate areas of skin are involved. If two or more skin conditions involve the same area of skin, then only the highest evaluation shall be used.

Problematic Issues

  • Malignant Skin Growths

Skin Systems

Diagnostic Code Name DBQ
7800 Burn scar(s) of the head, face, or neck; scar(s) of the head, face, or neck due to other causes; or other disfigurement of the head, face, or neck Scars/Disfigurement
7801 Burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are associated with underlying soft tissue damage Scars/Disfigurement
7802 Burn scar(s), or scar(s) due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage Scars/Disfigurement
7804 Scar(s), unstable or painful Scars/Disfigurement
7805 Scars, other and other effects of scars evaluated under diagnostic codes 7800, 7801, 7802 and 7804 Scars/Disfigurement

Skin Lesions

Diagnostic Code Name DBQ Acronym
7806 Dermatitis or eczema Skin Diseases ---
7807 American (New World) leishmaniasis (mucocutaneous, espundia) Skin Diseases LSHR
7808 Old World leishmaniasis (cutaneous, Oriental sore) Skin Diseases LSHR
7809 Discoid lupus erythematosus Skin Diseases LE
7811 Tuberculosis luposa (lupus vulgaris), active or inactive Skin Diseases ---
7813 Dermatophytosis (ringworm: of body, tinea corporis; of head, tinea capitis; of feet, tinea pedis; of beard area, tinea barbae; of nails, tinea unguium; of inguinal area (jock itch), tinea cruris; tinea versicolor) Skin Diseases DMT
7815 Bullous disorders (including pemphigus vulgaris, pemphigus foliaceous, bullous pemphigoid, dermatitis herpetiformis, epidermolysis bullosa acquisita, benign chronic familial pemphigus (Hailey-Hailey), and porphyria cutanea tarda) Skin Diseases ---
7816 Psoriasis Skin Diseases PS
7817 Erythroderma Skin Diseases ---
7818 Malignant skin neoplasms (other than malignant melanoma) Skin Diseases ---
7819 Benign skin neoplasms Skin Diseases ---

Skin Infections/Other

Diagnostic Code Name DBQ Acronym
7820 Infections of the skin not listed elsewhere (including bacterial, fungal, viral, treponemal and parasitic diseases) Skin Diseases ---
7821 Cutaneous manifestations of collagen-vascular diseases not listed elsewhere (including scleroderma, calcinosis cutis, subacute cutaneous lupus erythematosus, and dermatomyositis) Skin Diseases ---
7822 Papulosquamous disorders not listed elsewhere (including lichen planus, large or small plaque parapsoriasis, pityriasis lichenoides et varioliformis acuta (PLEVA), lymphomatoid papulosus, mycosis fungoides, and pityriasis rubra pilaris (PRP)) Skin Diseases ---
7823 Vitiligo Skin Diseases VIT
7824 Diseases of keratinization (including ichthyoses, Darier's disease, and palmoplantar keratoderma) Skin Diseases ---
7825 Chronic urticaria Skin Diseases UT, URT
7826 Vasculitis, primary cutaneous Skin Diseases VASC
7827 Erythema multiforme; Toxic epidermal necrolysis Skin Diseases EM
7828 Acne Skin Diseases ---
7829 Chloracne Skin Diseases ---
7830 Scarring alopecia Skin Diseases ---
7831 Alopecia areata Skin Diseases AA
7832 Hyperhidrosis Skin Diseases ---
7833 Malignant melanoma Skin Diseases MM


Diagnostic Code Name
7899-7828 Acne vulgaris
7899-7820 Condylomata accuminata (genital warts)
7899-7829 Cystic acne
7899-7820 Folliculitis
7899-7820 Herpes zoster/Shingles
7899-7820 Herpes simplex
7899-7820 Intertrigo
7899-7820 Plantar warts


The rating schedule for skin was updated on August 13, 2018. To view the historical rating schedule, please click the link below.