Citation Nr: 21006420 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 17-36 399A DATE: February 4, 2021 ORDER Service connection for folliculocentric lichenoid spongiosis and pustule with psoriasiform dermatitis and underlying suppurative folliculitis is granted. FINDING OF FACT The Veteran’s currently diagnosed folliculocentric lichenoid spongiosis and pustule with psoriasiform dermatitis and underlying suppurative folliculitis had its onset in service. CONCLUSION OF LAW The criteria for service connection for folliculocentric lichenoid spongiosis and pustule with psoriasiform dermatitis and underlying suppurative folliculitis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1998 to November 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in October 2015 by a Regional Office (RO) of the Department of Veterans Affairs (VA). In November 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. At such time, the Veteran waived Agency of Original Jurisdiction (AOJ) consideration of the evidence received since the issuance of the May 2017 statement of the case. 38 C.F.R. § 20.1305(e). The undersigned also held the record open for 30 days for the receipt of additional evidence; however, none has been received to date. Entitlement to service connection for a skin disorder other than service-connected pseudofolliculitis barbae (PFB) with acne. The Veteran is seeking service connection for a skin disorder affecting his bilateral lower extremities, which he asserts initially manifested during service as a result of environmental conditions and/or irritation caused by his service uniform. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996) [(table)]. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). As an initial matter, the Board notes that the Veteran is currently diagnosed with a skin disorder located on his bilateral lower legs, which has been identified as folliculocentric lichenoid spongiosis and pustule with psoriasiform dermatitis and underlying suppurative folliculitis (folliculitis), per a skin biopsy performed in December 2015. Moreover, the Board finds that the evidence of record corroborates the Veteran report that this skin disorder, which affects the calf portion of both of his lower legs, initially manifested during service. Specifically, the Veteran’s service treatment records include a June 2006 Report of Medical History wherein he reported a skin disorder affecting his right calf, which he referred to as eczema, presumably using this term for lack of a better description, as no clinician had properly diagnosed this skin disorder. One month after the Veteran’s separation from service, a December 2006 treatment record reflects treatment for several erythematous papules and pustules centered on follicles of the posterior right calf, which were assessed as folliculitis. A July 2007 treatment record continues to reflect the Veteran’s ongoing treatment for this folliculitis, which was deemed resistant to treatment. In May 2015, the Veteran was assessed with lichen planus of the bilateral lower extremities, noting that he had been seen by dermatology in May 2012 with intermittent flares of such disorder, despite treatment with fluocinonide cream. In July 2015, the Veteran was noted to have follicular plugging and psoriasiform hyperplasia, per a prior skin biopsy of his right calf, and the treating clinician then ordered another skin biopsy, which was conducted in December 2015. As noted previously, such resulted in diagnoses of folliculocentric lichenoid spongiosis and pustule with psoriasiform dermatitis and underlying suppurative folliculitis. The Board finds that this chronology of treatment supports the Veteran’s reports of the onset of his current folliculitis during service, as his symptoms reported during service were affirmatively diagnosed as folliculitis one month after his separation of service and have persisted such time. Consequently, the Board resolves all doubt in favor of the Veteran and finds that his currently diagnosed folliculitis had its onset in service. Thus, service connection for such disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. In reaching such determination, the Board acknowledges that VA medical opinions obtain during the pendency of the appeal in June 2015 and May 2017 did not find a correlation between the Veteran’s currently diagnosed eczema and his military service. However, such medical opinions address the etiology of eczema, which is not the disorder for which the Veteran is seeking service connection, as he reported during his November 2020 Board hearing. Therefore, as these opinions do not address the etiology of the Veteran’s folliculitis, the Board finds that they are of no probative value in the instant analysis. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (holding that to have probative value, the opinion provider must be fully informed of the pertinent factual premises, provide a fully articulated opinion, and provide a supportive reasoned analysis). A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Northcutt, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.