This single-case study reported the relapsing and remitting nature of both LyP and its potential of developing cutaneous T-cell lymphoma and NB-UVB phototherapy as a new modality of treatment of early-stage mycosis fungoides in these patients. Zanolli MD. Clinical experience suggests that potent topical corticosteroids (groups one to three) may be used for symptomatic relief, and may be sufficient pharmacologic therapy for mild cases. % Evidence-Based Medicine [CD-ROM]. 2002;147(4):743-747. de Souza A, Camilleri MJ, Wada DA, et al. London, UK: British Society for Haematology; 2005. The papules of LyP continued to appear but she remained free of lesions of mycosis fungoides 10 months following cessation of NB-UVB therapy. Am J Clin Dermatol. 2015;33(4):697-702. 2017;31(2):221-235. The lesions of lymphomatoid papulosis responded to intermittent courses of oral methotrexate. Polymorphous light eruption can be classified into 4 severity groups: Khafagy and associates (2013) compared the effectiveness of PUVA versus NB-UVB in the treatment of chronic urticarial (CU). Riemann H, High WA. Ultraviolet phototherapy management of moderate-to-severe plaque psoriasis. 2003;149(6):1095-1107. Elmets CA. Chronic actinic dermatitis: Two patients with successful management using narrowband ultraviolet B phototherapy with systemic steroids. Hodak E, Pavlovsky L. Phototherapy of mycosis fungoides. Procedure Codes 19355 Mastectomy for gynecomastia However, narrow-band UVB is not mentioned as a therapeutic option. De Rie MA, Sommer A, Hoekzema R, Neumann HA. Photochemotherapy; tar and ultraviolet B or petrolatum and ultraviolet B. CPT CD30, a helper T-cell marker specifically expressed in tumor cells was analyzed by immunohistochemical (IHC) staining and the result showed that CD30-negative or only scattered CD30-positive cells were present; thus, a diagnosis of type B LyP was made. The guidelines state that, although there are no studies that document the efficacy or safety of home light therapy for patients with atopic dermatitis, or that contrast its use to in-office phototherapy, results similar to home phototherapy for psoriasis might be expected. Br J Dermatol. 2003;4(6):399-406. In: BMJ Clinical Evidence. OkAX5;nQ{BWSJ Kf V@(VX0Gl_`\RQk_i=0TFx24vDK P Db}1`w=W )T+Yj{f/I {b9Dc X%F^lZ?_/59]6$L54[4qyS$_A+'pRT.G[8)c. Cologne, Germany: German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information (DAHTA) (DIMDI); 2006. No AEs occurred. 2014;8(6):1927-1933. Wolff K. Treatment of cutaneous mastocytosis. Waltham, MA: UpToDate; reviewed December 2017. The most proven regimen in the literature appeared to be methotrexate, with or without concurrent narrow-band UVB phototherapy. The perception of pruritus severity was examined using the visual analogue scale (VAS) before starting the treatment and at each control. Furthermore, an UpToDate review on Vulvar lichen sclerosus (Cooper and Arnold, 2021) does not mention narrow-band ultraviolet B (NB-UVB) as a management / therapeutic option. Two cases of type B LyP were identified; and the literature was reviewed to summarize the clinical outcomes and pathology of LyP and its treatment. Indolent systemic mastocytosis (ISM) is characterized by red-brownish and pruriginous maculopapular lesions, a bone marrow infiltration without functional impairment and an indolent clinical course with a good prognosis. Am J Clin Dermatol. Cochrane Database Syst Rev. Br J Dermatol. Hofer A, Cerroni L, Kerl H, Wolf P. Narrowband (311-nm) UVB therapy for small plaque parapsoriasis and early-stage mycosis fungoides. Topical psoralen-ultraviolet A therapy for palmoplanar dermatoses: Experience with 35 consecutive patients. 2016;32(5-6):238-246. Koreck AI, Csoma Z, Bodai L, et al. J Am Acad Dermatol. Improvement is generally seen after 20 to 40 treatments. J Am Acad Dermatol. For detailed information about Humanas claim payment inquiry process, review the claim payment inquiry process guide (300 KB). It may be reported using the CPT 96999, but the CPT codes for 96900-96910 for light box might also be used. Efficacy of ultraviolet A1 phototherapy in recalcitrant skin diseases. Lowe NJ. Rongioletti F. Localized lichen myxedematosus. Duarte I, Nina BI, Gordiano MC, et al. J Am Acad Dermatol. Waltham, MA: UpToDate; reviewed November 2019. Pichon-Riviere A, Augustovski F, Garcia Marti S, et al. 2010;21(6):326-330. Furthermore, an UpToDate review on Lymphomatoid papulosis (Kadin, 2022) states that For patients with extensive or symptomatic disease, scarring, or cosmetic concerns, we suggest low-dose methotrexate as the initial therapy (Grade 2C) For patients for whom methotrexate is contraindicated and for patients with LyP that does not respond to methotrexate, we suggest psoralen and ultraviolet A (PUVA) therapy (Grade 2C). 2000;142(1):39-43. After maintenance phototherapy was discontinued, 7 patients (23% ) had a sustained disease-free interval lasting more than 58 months (median of greater than 90 months). 2017;70(5):638-655. Therapy resistant idiopathic scleredema: An underlying pathology not always present. Lau FH, Powell CE, Adonecchi G, et al. These investigators carried out a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies examining PL treatment including 3 or more subjects and published in English between January 1, 1970 and April 15, 2019. Consecutive patients admitted with a positive COVID-19 PCR were screened for eligibility. Koek MB, Buskens E, van Weelden H, et al. 2008;18(6):667-670. Diagnosis and management of granuloma annulare. Facial lesions should be treated with lower potency topical corticosteroids (groups six to seven). Home ultraviolet light booths or ultraviolet lamps, as well as replacement bulbs sold by prescription only, for persons eligible for home UVB phototherapy. 2016;74(1):27-58. Narrow-band UVB phototherapy for the following indications: Cutaneous mastocytosis (after conventional therapies have failed); Kyrle disease (perforating dermatosis) that is refractory to topical or intralesional therapy; Photodermatoses (e.g., actinic dermatitis and solar urticaria; Prurigo nodularis that is refractory to topical or intralesional corticosteroids; Uremic pruritusthat is refractory to emollients, topical analgesics and oral antihistamines or gabapentin. CPT codes are the numeric codes used to identify different medical services, procedures and items for billing purposes. R1. The most recent recurrence of mycosis fungoides was treated with NB-UVB therapy. Less potent topical corticosteroids, such as mometasone furoate 0.1 % ointment or cream, can be used for facial lesions For patient with oral erosive lichenoid drug eruption, we suggest topical corticosteroids as first line treatment (Grade 2B). Berg M, Ros AM, Berne B. Ultraviolet A phototherapy and trimethylpsoralen UVA photochemotherapy in polymorphous light eruption -- a controlled study. Most insurance carriers cover 96900. If they won't a Is CPT 96900 correct for billing Excimer Laser for Vitiligo? Correction of inverted nipples are considered cosmetic and, therefore, non-covered for any other indication. 1999;(2):CD001168. Eur J Dermatol. CPT Code 96900. Section 3. Weibel L. Localized scleroderma (morphea) in childhood. The authors concluded that among their pediatric patients, these investigators noted a predominance of CD8(+) LyP, which did not appear to have an aggressive course. Loading 6 0 obj Medicare Location. Unfortunately, the lesions relapsed, whenever phototherapy was discontinued. Semin Dermatol. Eur J Rheumatol. Sunscreens should be broad spectrum, with both UVA and UVB protection. After a complete response is achieved, the frequency of therapy is tapered very slowly during the maintenance period and then discontinued. Waltham, MA: UpToDate; reviewed December 2021. Gerstner GL. This Clinical Policy Bulletin may be updated and therefore is subject to change. J Am Acad Dermatol. For FREE Trial. in order to bill the 96910 can the patient apply (we use Vanicream) themselves or does the nurse have to do it? Helsinki, Finland: Duodecim Medical Publications Ltd.; June 18, 2004. 2010;62(1):114-135. Phototherapy for atopic eczema with narrow-band UVB. <> sOi\\sr Cather J, Menter A. Waltham, MA: UpToDate; reviewed November 2019. The descriptor for these codes is very precise: Laser for the treatment of Psoriasis. Narrowband UVB phototherapy can be administered 3 times per week, starting with a dose equivalent to 50 to 70% of the MED. Guidelines for phototherapy of mycosis fungoides and Sezary syndrome: A consensus statement of the United States Cutaneous Lymphoma Consortium. 1993;28(2 Pt 1):227-231. Darier's disease: Epidemiology, pathophysiology, and management. Therapie. Clearance rates with the different modalities were hardly comparable between different studies, ranging approximately between 70 % and 100 %. Newland K, Marshman G. Success treatment of post-irradiation morphoea with acitretin and narrowband UVB. Lymphomatoid papulosis associated with recurrent cutaneous T-cell lymphoma. Photosensitivity disorders: Cause, effect and management. Raler F, Lukacs J, Elsner P. Treatment of eosinophilic cellulitis (Wells syndrome) - a systematic review. Hanifin JM, Cooper KD, Ho VC, et al. They usually do not have too many restrictions on this code, since it only pays about $20. wGj%{aC?'R&M|*,uM} V^At9lnZWBW+%Pu Db:V~;v*(.C[6*-/E Treatments are usually given 2 to 3 times per week over 5 to 6 weeks. The number of treatments needed to attain symptom relief was significantly lower in the PUVA group, but the mean exposure dose was significantly higher, if compared to the NB-UVB group. Gastroenterology procedures included in CPT code ranges 43753-43757 and 91000-91299 are frequently complementary to endoscopic procedures. Narbutt J, Torzecka JD, Sysa-Jedrzejowska A, Zalewska A. Waltham, MA: UpToDate; reviewed November 2013. 2006;(1):CD001433. 2022;31(7):1109-1115. Modifier Lookup Tool This tool is intended to assist suppliers in determining potential modifiers that may be used in billing DMEPOS HCPCS codes. Watsky K. Prurigo nodularis. In contrast, a small randomized trial showed narrowband UVB to be as effective as PUVA. Because narrowband UVB is easier to administer, it is often preferred to PUVA therapy for patients with PMLE. 5 0 obj Zheng et al (2014) attempted to improve the level of diagnosis and differential diagnosis of LyP. Reynolds NJ, Franklin V, Gray JC, et al. UpToDate [online serial]. Dermatology. These researchers stated that further studies are needed. Claes C, Kulp W, Greiner W, et al. Taylor CR, Hawk JL. Broad spectrum sunscreens with an SPF of at least 30 should be regularly used, For patients with active lesions, we suggest treatment with potent topical corticosteroids (groups one to three). Procedure Codes 11920 11921 19350 19499 Correction of inverted nipples may be considered medically necessary when performed in an attempt to restore the ability to breast feed. Interventions for vitiligo. McMullin MF, Bareford D, Campbell P, et al. Histopathologic findings include multinucleated giant cells For patients with symptomatic disease involving a limited skin area (e.g., the extremities), we suggest topical corticosteroids rather than oral corticosteroids (Grade 2C). Monovalent vaccines are out and bivalent vaccines are in. Storbeck K, Holzle E, Schurer N, et al. Primary outcomes were safety and effectiveness, defined as persistent or painful erythema and 28-day mortality. List of CPT/HCPCS Codes. Beani JC, Jeanmougin M. Narrow-band UVB therapy in psoriasis vulgaris: Good practice guideline and recommendations of the French Society of Photodermatology. Mycosis fungoides was treated with oral psoralen and UVA phototherapy with good response. Many companies require employees to sign noncompete clauses before they will hire you. Haeberle MT. 1997;195(4):359-361. NB-UVB phototherapy is standard of care (SOC) in a number of immune-dysregulated diseases. The lesions typically present within 1 year of radiation therapy and extend beyond the radiated field. To plug inpatient facility revenue drains, subscribe to DRG Coder today. Comparative study of systemic psoralen and ultraviolet A and narrowband ultraviolet B in treatment of chronic urticaria. 2017;15(2):151-157. 2002;127(2):156-159. Lymphomatoid papulosis misdiagnosed as pityriasis lichenoides et varioliformis acuta: Two case reports and a literature review. Clin Exp Dermatol. WebCODING/BILLING INFORMATION The inclusion or exclusion of a code in this section does not necessarily indicate coverage. However, there is no specific CPT code for light therapy for vitiligo. The authors concluded that these findings indicated that home phototherapy may be a therapeutic option for treatment of selected patients with early MF. Photodermatol Photoimmunol Photomed. Dermatol Ther. 2001;357(9273):2012-2016. The authors suggested that NB-UVB phototherapy as 1st-line treatment. In order to avoid under-diagnosis and misdiagnosis, physicians should examine suspected patients by histopathological and IHC examination. In a retrospective study, these investigators reviewed the clinical and histopathologic features of LyP in pediatric patients. The 2 patients exhibited symptoms with papulonodular lesions, the centers of which gradually underwent ulceration and necrosis. Ko MJ, Yang JY, Wu HY, et al. Clark C, Dawe RS, Evans AT, et al. London, UK: BMJ Publishing Group; August 2007. REIMBURSEMENT INFORMATION: Refer to section entitled POSITION STATEMENT. UVA1 phototherapy should not be used for patients with UVA-sensitive photodermatoses or photosensitive atopic dermatitis or patients taking photosensitizing drugs. Since then, she has had recurrence of mycosis fungoides following the cessation of phototherapy; but exhibited no evidence of systemic involvement. Available at: https://emedicine.medscape.com/article/1070090-overview. The interpretation of the results was biased by the possible auto-resolution of the disease, the sample heterogeneity between children and adults and the short follow-up period of the studies. In particular, the most common cutaneous symptoms are urticarial rash and mild-to-high pruritus. Available at:http://emedicine.medscape.com/article/1123031-treatment. [QUOTE="gracigoo, post: 323015, member: 48053"] Comparisons were made via non-parametric exact tests. A complete clinical and histologic response to home phototherapy occurred in 23 patients (74 %) with a maximum duration of the response from 5 months to more than 15 years (median of 51 months). An UpToDate review on UVB therapy (broadband and narrowband) (Honigsmann, 2021) does not mention drug-related hypersensitivity reaction as an indication for UVB therapy. The papules of lymphomatoid papulosis continued to appear but she remained free of lesions of mycosis fungoides 10 months after cessation of NB-UVB therapy. Guidelines of care for the management of atopic dermatitis. 2006;74(10):1729-1734. Sidbury R, Davis DM, Cohen DE, et al. The authors concluded that the findings of this study provided evidence that NB-UVB phototherapy was useful for the treatment of the cutaneous symptoms and pruritus in ISM. Am J Clin Dermatol. Article revised and published on 12/09/2021 effective for dates of service on and after 12/12/2021. Dermatology. Prompt resolution was achieved with NB-UVB phototherapy and avoidance of re-challenge. 0_%"F~ ~@kj#YgeOgQ3ke`t[() Am J Hematol. Home phototherapy (UVB) for the treatment of cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome), and indications other than psoriasis and atopic dermatitis (eczema). In a review on Phototherapy of mycosis fungoides (Hodak and Pavlovsky, 2015), home phototherapy is not mentioned as therapeutic option. Cochrane Database Syst Rev. Thanks, Read a CPT Assistant article by subscribing to. Phototherapy - Prophylactic phototherapy with low dose PUVA (psoralens plus UVA) or UVB in early spring to induce tolerance to sun exposure may be an option for patients who are expected to develop significant symptoms during the spring or summer. Treatment with systemic agents is often necessary, and can be managed by a dermatologist. The AMA released a CPT code for use in non-facility settings for the expense related to supplies, equipment and staff time and activities for visits performed during the PHE due to respiratory-transmitted infectious disease, effective Sept 8, 2020 Some commercial payers are recognizing the paying a small amount for this code. J Dermatolog Treat. Overview of cutaneous lupus erythematosus. Alabdulkareem AS, Abahussein AA, Okoro A. Code range 96900- 96999. WebCPT codes covered if selection criteria are met: 96900: Actinotherapy (ultraviolet light) 96913: Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive Br J Dermatol. There was a relapse after 9 months with a good response after 6 more sessions of treatment. Clin Exp Dermatol. Q. 2018. Alopecia Mucinosa. Vitiligo is not an inflammatory disease and therefor the use of this code is improper. Ellis E, Scheinfeld N. Eosinophilic pustular folliculitis: A comprehensive review of treatment options. xZrF}WV%U /#_bnIm~@JBDAJQ>*? DkEtOsy&KI*n9W:L[dnyJJ\U@R\.Ko(D.L/0WEly~Y`Z}%wsV4@JB9l ~*rEE4"DOk~ q{v2yc-:ZTOu$1h33c0&LsFW% MHCr8h.k._TpCWXoKk;twJY-I5N7sqHF' The dose is increased during subsequent treatments as tolerated by the patient. Kreutz M, Karrer S, Hoffmann P, et al. The FTC proposes to ban noncompete clauses in employment contracts. Try entering any of this type of information provided in your denial letter. endobj Kalfa M, Koanaogullar H, Zihni FY, et al. 2006;154(4):701-711. Veith W, Deleo V, Silverberg N. Medical phototherapy in childhood skin diseases. 2015;2(4):163-164. 2000;4(40):1-125. Bohjanen K, Miller DD. 1982;6(3):355-362. Arch Dermatol. Dermatol Clin. 2001;20(1):27-37. 103.2: 202.10-202.18: 202.20-202.28: 691.8: 692.72: 696.1: 696.2: 697.0: 705.81: 709.01* For CPT Codes 96912 and 96913. 2015;31(2):75-82. van Coevorden AM, Kamphof WG, van Sonderen E, et al. We generally use a super-potent topical corticosteroid (e.g., clobetasol propionate 0.05 %) ointment or cream twice daily for 2 to 4 weeks. 1995;132(6):956-963. Cooper SM, Arnold SJ. Bath PUVA and psoriasis: Is a milder treatment a worse treatment? Interventions for mycosis fungoides. 1977;297(3):136-138. 2012;26 Suppl 3:11-21. Long-term results of topical PUVA in necrobiosis lipoidica. Practice Management Center. 2002;3(3):159-173. 2004;50(3):391-404. Lau et al (2022) stated that COVID-19 morbidity and mortality are driven by poor immune regulation. Minimal benefit from photochemotherapy for alopecia areata. J Am Acad Dermatol. The lesions of LyP responded to intermittent courses of oral methotrexate. Home PUVA treatment because of insufficient evidence of its safety. There are also contraindications for patients with significant hepatic impairment and for those taking warfarin or phenytoin. WebSUNY Downstate Health Sciences University, School of Health Professions Medical Billing and Coding program is a certificate program designed to assist individuals entering the field of medical billing and coding, or preparing for certification. A Medicare reimbursement rate is the amount of money that Medicare pays doctors and other health care providers for the services and items they administer to Medicare beneficiaries. The American Academy of Professional Coders (AAPC) 2015 data showed that the average wage for a Certified In retrospective cohort studies, NBUVB has demonstrated superior efficacy and decreased toxicity compared with BBUVB, but not PUVA, with complete response rates ranging from 54 to 90 %. In one randomized trial, treatment was successful in 92% of patients treated with PUVA, compared with 62% of patients treated with broadband UVB. Tan B, Foley P. Guttate psoriasis following Ecstasy ingestion. These investigators reported a case of LyP in a 13-year-old Caucasian girl who presented with a 6-month history of recurrent papular lesions on the left upper arm. The Centers for Medicare 038 Medicaid Services CMS issued April 10 the Inpatient Prospective Payment SystemLongTerm Care Hospital IPPSLTCH proposed rule for fiscal year FY 2024. In a click, check the DRG's IPPS allowable, length of stay, and more. 2016;30(9):1465-1479. In: Principles and Practice of Dermatology. <> 2006;31(1):65-67. Australas J Dermatol. Accessed February 15, 2011. The diagnosis coding for vitiligo remains straightforward under the earlier ICD-9 (709.01) and current ICD-10 (L80). d)5"k{vN&/"vF*+'}> /bhE~Vrs'YV@?N?+7ZCWuQ.OnufG\W;W[1ouJ? Australas J Dermatol. Int J Dermatol. Furthermore, an UpToDate review on Erythema annulare centrifugum (Haeberle, 2021) does not mention NB-UVB as a management / therapeutic option. Polymorphous light eruption. It is included in the World Health Organization (WHO) classification of cutaneous lymphomas. 2009;61(6):993-1000. The main drawbacks of this trial were that this was a single-case study; and the hypersensitive rash was caused by the ingestion of an Ecstasy tablet. Weberschock T, Strametz R, Lorenz M, et al. <> For each patient, total numbers of PUVA or NB-UVB exposures, the cumulative UV dose (J/cm2 ), serum tryptase profile, and pruritus, before and after treatment, according to the VAS were considered. Symptoms are self-limited and resolve within several weeks. Fidelis had gave us a same issue and now united healthcare. Pugashetti R, Lim HW, Koo J. Broadband UVB revisited: Is the narrowband UVB fad limiting our therapeutic options? WM Sams Jr, PJ Lynch, eds. Tan AWH, Giam YC. An UpToDate review on Lichenoid drug eruption (drug-induced lichen planus) (Ziemer, 2021) states that Lichenoid granulomatous dermatitis is a histopathologic reaction pattern with vacuolar alteration of the basal layer with necrotic keratinocytes and a chronic, inflammatory infiltrate consisting of lymphocytes, eosinophils, plasma cells, and macrophages forming variable types of granulomas. Waltham, MA: UpToDate; reviewed December 2015. In both cases, if only light exposure is provided, the use of CPT code 96900 would be the only acceptable way to bill. Ann Dermatol. Hautarzt. Klecz RJ, Schwartz RA. 1995;133(6):914-918. Waltham, MA: UpToDate; reviewed December 2022. Treating providers are solely responsible for medical advice and treatment of members. Vogelsang GB, Wolff D, Altomonte V, et al. Treatment of uremic pruritus with narrowband ultraviolet B phototherapy: An open pilot study. Article revised and published on 12/09/2021 effective for dates of service on and after 12/12/2021. Australas J Dermatol. J Am Acad Dermatol. This may indicate a beneficial difference at certain time-points, but the effect appeared marginal. 1985;13(4):675-677. Medscape. UpToDate [online serial]. Histopathologic examination showed a diffuse cellular infiltration of small and medium-sized T lymphocytes CD30+ in the superficial dermis. Guidelines for the Diagnosis, Investigation and Management of Polycythaemia/Erythrocytosis. Oral erythromycin with or without topical corticosteroids and low-dose methotrexate as 2nd-line therapies. Grover's disease (transient and persistent acantholytic dermatosis). 3) Contact your MAC. yV*@)o+ aINx@YGz6@Su68 yJHk9H@{m}bU ]^%lN&g++^uHrw{w%st systemic corticosteroids and methotrexate) have failed], Other specified and unspecified acute skin changes due to ultraviolet radiation, Other skin changes due to chronic exposure to nonionizing radiation [actinic dermatitis], Keratosis follicularis et parafollicularis in cutem penetrans [Kyrle disease], Drug rash with eosinophilia and systemic symptoms syndrome [hypersensitive rash], Allergic and Irritant contact dermatitis [superficial mixed-cell dermatitis], Generalized skin eruption due to drugs and medicaments taken internally [erythematous hyper-pigmented macules/papules], Lichen simplex chronicus [lichenoid dermatitis], Lichenoid drug reaction [lichenoid dermatitis], Other melanin hyperpigmentation [erythematous hyper-pigmented macules/papules], Pigmented purpuric dermatosis [erythematous hyper-pigmented macules/papules], Other specified disorders of pigmentation [melasma][ progressive macular hypomelanosis] [erythematous hyper-pigmented macules/papules], Disorder of pigmentation, unspecified [skin hypo-pigmentation from scarring], Liver and biliary tract disorders in pregnancy [cholestasis of pregnancy], Other specified congenital malformations of skin, Rash and other nonspecific skin eruption [hypersensitive rash], Unspecified adverse effect of drug or medicament [drug-related hypersensitivity reaction], Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B, Psoriasis [severe, that affects more than 10% of body surface area]. Millard TP, Hawk JL. Oral psoralen photochemotherapy (PUVA) for pruritus associated with polycythemia vera and myelofibrosis [letter]. <> 2006;(1):CD003263. Treister N, Li S, Lerman MA, et al. J Am Acad Dermatol. Ont Health Technol Assess Ser. J Am Acad Dermatol. Walker D, Jacobe H. Phototherapy in the age of biologics. de Souza et al (2009) stated that LyP is a cyclic papulonodular eruption that is clinically benign and histologically malignant.
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