38 CFR Part 4 — 38 CFR § 4.118
Diseases of keratinization — VA Diagnostic Code 7824
Skin
Diagnostic code
7824
38 CFR § 4.118 lists Diagnostic Code 7824 as “Diseases of keratinization (including icthyoses, Darier's disease, and palmoplantar keratoderma).” The next row says to evaluate under the General Rating Formula for the Skin. The formula header names DC 7824. The last formula line says its disfigurement-or-scars instruction does not apply to DC 7824. The schedule spells the first example “icthyoses.” Appendix B to Part 4 indexes “Keratinization, diseases” at 7824.
Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.118 source note prints 67 FR 49596, July 31, 2002; 67 FR 58448, 58449, Sept. 16, 2002; 73 FR 54710, Oct. 23, 2008; 77 FR 2910, Jan. 20, 2012; 83 FR 32597, July 13, 2018; 83 FR 38663, Aug. 7, 2018.
The rating criteria at each level
7824 Diseases of keratinization (including icthyoses, Darier's disease, and palmoplantar keratoderma)
Rating %: —
Criteria (verbatim). Evaluate under the General Rating Formula for the Skin
| Rating % | Criteria (verbatim) |
|---|---|
| — | Evaluate under the General Rating Formula for the Skin |
General Rating Formula For The Skin For DCs 7806, 7809, 7813-7816, 7820-7822, and 7824
Rating %: 60
Criteria (verbatim). At least one of the following
Rating %: —
Criteria (verbatim). Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or
Rating %: 60
Criteria (verbatim). Constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period
Rating %: 30
Criteria (verbatim). At least one of the following
Rating %: —
Criteria (verbatim). Characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or Systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period
Rating %: 10
Criteria (verbatim). At least one of the following
Rating %: —
Criteria (verbatim). Characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or
Rating %: —
Criteria (verbatim). At least 5 percent, but less than 20 percent, of exposed areas affected; or
Rating %: —
Criteria (verbatim). Intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period
Rating %: 0
Criteria (verbatim). No more than topical therapy required over the past 12-month period and at least one of the following
Rating %: —
Criteria (verbatim). Characteristic lesions involving less than 5 percent of the entire body affected; or
Rating %: —
Criteria (verbatim). Characteristic lesions involving less than 5 percent of exposed areas affected
Rating %: —
Criteria (verbatim). Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability. This rating instruction does not apply to DC 7824
| Rating % | Criteria (verbatim) |
|---|---|
| 60 | At least one of the following |
| — | Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or |
| 60 | Constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period |
| 30 | At least one of the following |
| — | Characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or Systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period |
| 10 | At least one of the following |
| — | Characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or |
| — | At least 5 percent, but less than 20 percent, of exposed areas affected; or |
| — | Intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period |
| 0 | No more than topical therapy required over the past 12-month period and at least one of the following |
| — | Characteristic lesions involving less than 5 percent of the entire body affected; or |
| — | Characteristic lesions involving less than 5 percent of exposed areas affected |
| — | Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability. This rating instruction does not apply to DC 7824 |
(a) For the purposes of this section, systemic therapy is treatment that is administered through any route (orally, injection, suppository, intranasally) other than the skin, and topical therapy is treatment that is administered through the skin.
(b) Two or more skin conditions may be combined in accordance with § 4.25 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.
The last formula line says: “Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability. This rating instruction does not apply to DC 7824.”
eCFR prints “At least one of the following” on its own row, with the percentage in the rating column, and prints the options on the following rows. A blank rating cell on this page marks an option row. On the 60 percent block, the rating column also shows 60 on the systemic-therapy row. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.
The formula header includes 7824. The disfigurement-or-scars instruction at the end of the formula does not apply to this code. DC 7815 is inside 7813-7816, so that instruction remains in the formula that rates bullous disorders. DC 7826 is primary cutaneous vasculitis. It is not in the formula header. It prints its own lines, and one of those lines repeats a disfigurement-or-scars instruction without the DC 7824 exception.
Source: 38 CFR § 4.118, Diagnostic Code 7824 and the General Rating Formula for the Skin, eCFR full-text XML for 2026-10-01.
What the words mean in your records
The parenthetical spells icthyoses
The DC 7824 title includes icthyoses, Darier's disease, and palmoplantar keratoderma. “Icthyoses” is the spelling in the 2026-10-01 row. The row then says to evaluate under the General Rating Formula for the Skin.
The exception is this code
The last formula line names DC 7800, DC 7801, DC 7802, DC 7804, and DC 7805, and then says that rating instruction does not apply to DC 7824.
Systemic therapy is not treatment through the skin
Section 4.118(a) says systemic therapy is treatment administered through any route other than the skin, and it lists orally, injection, suppository, and intranasally. Topical therapy is treatment administered through the skin.
Evidence that speaks to each level
60, 30, 10, or 0 under the skin formula
What the rater needs to see. At least one finding in that block: the percent of the entire body or of exposed areas affected by characteristic lesions, or the systemic or topical therapy the block describes over the past 12-month period.
Where that usually lives. The skin examination and the treatment record for those 12 months.
The instruction that does not apply
What the rater needs to see. The last formula line’s disfigurement-or-scars rating is the instruction the schedule says does not apply to DC 7824.
Where that usually lives. The same formula. Scar codes remain separate diagnostic codes. They are not the last line of this formula for this code.
VA’s public DBQ list, checked October 5, 2026, names “Skin Diseases” under Dermatological. The file is Skin Diseases.
The exam form
DC 7824 points to the General Rating Formula for the Skin and carries the exception on the last formula line. This page does not say the form replaces that text.
Related codes and how they interact
Same area of skin uses the highest evaluation.
Section 4.118(b) says two or more skin conditions may be combined under § 4.25 only if separate areas of skin are involved. If they involve the same area, only the highest evaluation shall be used.
Secondary conditions and presumptions
The 2026-10-01 text of 38 CFR § 3.309 does not contain “keratinization,” “icthyoses,” or “Darier's.”
A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.
Short answers
What is the VA rating for diseases of keratinization?
Under 38 CFR § 4.118, Diagnostic Code 7824 is evaluated under the General Rating Formula for the Skin at 60, 30, 10, or 0 percent. The formula’s disfigurement-or-scars instruction does not apply to DC 7824. Education only. VA decides on the evidence.
Is DC 7824 named in § 3.309?
The 2026-10-01 text of § 3.309 does not contain “keratinization,” “icthyoses,” or “Darier's.”
FAQ
How does VA rate diseases of keratinization?
DC 7824 says to evaluate under the General Rating Formula for the Skin. That formula prints 60, 30, 10, and 0. The last line, rating disfigurement or scars, says that instruction does not apply to DC 7824. Education only.
Why does the title say icthyoses?
That is the spelling in the 2026-10-01 text of § 4.118: “including icthyoses, Darier's disease, and palmoplantar keratoderma.”
What counts as systemic therapy?
Section 4.118(a) says systemic therapy is treatment administered through any route (orally, injection, suppository, intranasally) other than the skin. Topical therapy is treatment administered through the skin.
Next steps
- Read the decision for DC 7824 and which skin-formula block was used, including the percent of skin or the therapy over the past 12-month period.
- The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
- Other skin codes are on the skin diagnostic-code index. The category page is skin conditions.
Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.
Other codes in this body system
Nearby catalog entries in Skin, ordered by diagnostic code number. All Skin codes
- DC 7816Psoriasis
- DC 7817Erythroderma
- DC 7818Malignant skin neoplasms
- DC 7819Benign skin neoplasms
- DC 7820Infections of the skin
- DC 7821Cutaneous manifestations of collagen-vascular diseases not listed elsewhere
- DC 7822Papulosquamous disorders not listed elsewhere
- DC 7823Vitiligo
- DC 7825Chronic urticaria
- DC 7826Vasculitis, primary cutaneous
- DC 7827Erythema multiforme
- DC 7828Acne
- DC 7829Chloracne
- DC 7830Scarring alopecia
- DC 7831Alopecia areata
- DC 7832Hyperhidrosis
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7824 • va.gov
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.