Citation Nr: 18143814
Decision Date: 10/22/18	Archive Date: 10/22/18

DOCKET NO. 15-40 394
DATE:	October 22, 2018
REMANDED ISSUE
Entitlement to an initial rating higher 10 percent for pseudofolliculitis barbae is remanded.
REASONS FOR REMAND
The Veteran served on active duty from June 1978 to August 1978. 
The Board regrets further delay, but additional development is necessary before the claim can be adjudicated. 
A VA examination from July 2013 and a January 2014 Dermatology Resident Note demonstrate that treatment for the Veteran’s pseudofolliculitis barbae includes constant or near constant application of hydrocerin cream, which has been classified as topical medication. A remand is necessary to clarify whether this cream can be considered as a systemic therapy.  The Veteran has asserted that he uses systemic therapy and the Court has indicated that these questions will often require a medical opinion.  See Burton v. Wilkie, CAVC 16-2037 (Sept/ 23, 2018).
The matter is REMANDED for the following action:
1. Update VA treatment records. 
2. Thereafter, forward the claims file to an appropriate examiner to determine whether the hydrocerin cream treatment noted constitutes a systemic therapy. It is in the discretion of the examiner if an additional physical examination is necessary. The examiner should answer the following questions: 
How does hydrocerin cream work to treat the Veteran’s pseudofolliculitis barbae, and is it “like” a corticosteroid or other immunosuppressive drug?
Does the hydrocerin cream affect the body as a whole in the treatment of the Veteran’s pseudofolliculitis barbae? 
The examiner should note, for example, a treatment may be said to affect the body as a whole if it circulates through the bloodstream. 

 
Nathaniel J. Doan
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S.SOLOMON