It was considered to be one of the "factors influencing health status and contact with health services" and "should not be used" for "primary mortality coding". It was also considered one of the "problems related to life-management difficulty". The condition is further defined as being a "state of vital exhaustion," which historically had been called neurasthenia.The ICD-10 also contained a medical condition category of "F43.8 Other reactions to severe stress. "In 2010 the Swedish Board of Health and Welfare added “exhaustion disorder” (ED; F43.8A) to the Swedish version of the ICD-10, the ICD-10-SE, representing what is typically called "burnout" in English. (See also sv:Utmattningssyndrom). Swedish sufferers of severe burnout had earlier been treated as having neurasthenia.The ICD-10-SE defined exhaustion disorder as consisting of:

A. Physical and mental symptoms of exhaustion during at least two weeks. The symptoms have developed in response to one or more identifiable stressors present for at least six months. B. The clinical picture is dominated by markedly reduced mental energy, as manifested by reduced initiative, lack of endurance, or increased time needed for recovery after mental effort. C. At least four of the following symptoms have been present, nearly every day, during the same 2-week period:

Concentration difficulties or impaired memory
Markedly reduced capacity to tolerate demands or to work under time pressure
Emotional instability or irritability
Sleep disturbance
Marked fatigability or physical weakness
Physical symptoms such as aches and pains, palpitations, gastrointestinal problems, vertigo or increased sensitivity to soundD. The symptoms cause clinically significant distress or impairment in occupational, social or other important respects.
In view of the very poor cure rate with standard excision, some surgeons combine the two methods: surgical excision of the lesion, then three months treatment of the area with imiquimod cream. Studies seem to conflict about the level of certainty associated with using imiquimod.Another treatment to be considered where standard margins cannot be achieved or cosmetics are a major consideration is ultra-soft x-ray/grenz-ray radiation.In the very elderly or those with otherwise limited life expectancy, the impact of major day surgery for excision with 5mm margins and large skin flap could be worse than doing nothing or the possibility of failed treatments with imiquimod or Grenz ray. References
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