Diagnostic Code 7809 · 38 CFR §4.118
Discoid lupus erythematosus (DLE) is a chronic autoimmune skin condition that causes thick, scaly, disc-shaped patches typically on the face, scalp, and ears. Unlike systemic lupus, DLE primarily affects the skin, though it can cause permanent scarring, hair loss, and skin color changes. Veterans may develop DLE triggered by sun exposure during deployments, environmental exposures, or stress of military service. The condition tends to be chronic with periods of flare and remission.
| Rating | Criteria |
|---|---|
| 0% | Less than 5% of the entire body or less than 5% of exposed areas affected, AND no more than topical therapy required during the past 12-month period. |
| 10% | At least 5% but less than 20% of the entire body, OR at least 5% but less than 20% of exposed areas affected, OR intermittent systemic therapy (corticosteroids or other immunosuppressive drugs) required for a total duration of less than 6 weeks during the past 12 months. |
| 30% | 20 to 40% of the entire body or 20 to 40% of exposed areas affected, OR systemic therapy (corticosteroids or other immunosuppressives) required for a total duration of 6 weeks or more, but not constantly, during the past 12 months. |
| 60% | More than 40% of the entire body or more than 40% of exposed areas affected, OR constant or near-constant systemic therapy (corticosteroids or other immunosuppressives) required during the past 12 months. |
Dermatology records documenting the diagnosis with biopsy confirmation are important. Photographs showing the extent of skin involvement during flares help document severity. Treatment records showing the medications used (topical, systemic, immunosuppressive) establish treatment needs. Service records linking onset or worsening to military service are necessary. Records of scarring, hair loss, or disfigurement support additional claims.
No. Discoid lupus is limited to the skin, while systemic lupus affects internal organs. They are rated under different diagnostic codes. However, about 5-10% of people with discoid lupus may eventually develop systemic lupus, so continued monitoring is important. If you develop systemic symptoms, that would be a separate claim.
Intense or prolonged sun exposure is a well-established trigger for discoid lupus in people who are genetically predisposed. If you served in sunny environments and developed DLE during or shortly after service, the connection between service-related sun exposure and the condition can support a service connection claim.