Recurrent oral and cutaneous infections associated with cyclic neutropenia

Recurrent skin and mucous membrane infections, occurring at regular intervals, should alert the clinician to the possibility of an unusual hematologic disorder known as cyclic or periodic neutropenia. This disease is characterized by a cyclic depression of neutrophils, occurring at intervals of 12 to 30 days (average 21 days) lasting from 5 to 8 days and accompanied by fever, malaise, and infections occurring in the skin and mucous membranes. The neutrophils in the peripheral blood regularly fall to low levels or disappear at this time. Between the periods of depression, the neutrophils increase but seldom rise to above 50% of the total. The leukocyte count is usually in the low normal range (4,000 to 5,000). The literature describing this rare disorder will be reviewed in this paper, and three cases will be reported. These cases are of particular interest, since a long period of observation (10 and