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Giant vulvar ulcers in the course of adult onset cyclic neutropenia

A 73 year old female was admitted to the Internal Medicine Unit of our hospital for fever, malaise, fatigue that started a week before admission. She complained of lesions on her genitalia that provoked difficulty in urination and reported similar episodes for which she had been hospitalized in a Gynecology Departement but no specific diagnosis has been made. On admission she had fever 39 Celsius and the skin examination revealed two giant ulcers on both right and left inner side of the thighs with raised erythematous sharp demarcated borders and purulent center, as well post -inflammatory healing lesions on the lower part of the abdomen (Fig. 1).