Diagnostic Code 7811 · 38 CFR §4.118
Lupus vulgaris is a form of cutaneous tuberculosis — a chronic skin infection caused by the tuberculosis bacterium. It produces distinctive reddish-brown nodules and plaques that can slowly expand and destroy skin, cartilage, and underlying tissue if untreated. Veterans may acquire this through tuberculosis exposure during deployments to regions where TB is common. The condition is rare in the US but occurs among veterans who served in endemic areas.
| 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. |
Biopsy confirming the tuberculosis organism in skin tissue is the definitive evidence. TB skin test or blood test results support the diagnosis. Treatment records showing anti-tuberculosis medication regimens document the severity. Deployment records to TB-endemic areas help establish where the exposure occurred. Photographs of skin lesions document the extent of involvement.
Yes. Cutaneous TB affects the skin specifically, while pulmonary TB affects the lungs. They are caused by the same bacterium but manifest differently and are rated under different diagnostic codes. However, having one form increases the likelihood of having or developing the other, so screening for both is important.
Active tuberculosis is a presumptive condition if it manifests to a compensable degree within three years after discharge. If you were diagnosed with cutaneous TB within that window, you may not need to prove a specific exposure event — the timing creates a presumption of service connection.