Recurrent impetiginized eczema as a presenting manifestation of cyclic neutropenia

A patient is described with a persistent, impetiginized dermatitis that worsened periodically, which was preceded by neutropenic episodes during which her circulating neutrophil count fell to 500-600/ml. Each episode lasted 24 h and had a 7-11 day periodicity. The importance of this case depends on the frequency and brevity of the neutrophil trough levels that made the dermatitis appear to be continuous. Similar cases may be more common than expected as isolated abnormal leukocyte counts may be disregarded as laboratory artefacts. Dermatologists should be cautious in managing patients with persistent atypical impetigo.