Uncommon presentation of hypereosinophilic syndrome.

The hypereosinophilic syndrome is a group of diseases characterised by persistent blood eosinophilia, defined as more than 1500 cells per micro liter [1], with end-organ involvement and no recognised secondary causes such as skin diseases, parasitic infection or allergy (Table). The sustained overproduction of eosinophils causes eosinophilic infiltration and release of mediators causing damage to multiple organs [2]. Cutaneous involvement occurs in more than 50% of patients, but it usually appears late in the disease and is of less importance than cardiac and other organ involvement [1]. We describe a patient with the hypereosinophilic syndrome (HES) in whom the initial manifestation of the disease was recurrent, severe mucosal ulcers involving the mouth and genitalia.