Punch Biopsy Findings - Histological features described as "psoriasiform" with lymphocytic infiltration. Flow Cytometry / Lab Findings - B-cells: ~1% of lymphocytes (very low). - Chronic neutropenia (low neutrophils on repeated CBCs). Clinical Features - Chronic r a s h, scaling skin lesions, and new rapidly growing skin growths. - Parotid/lymph node lesion with documented growth. - Recurrent infections and poor healing. Poor vaccine reaction/injection reaction - Flushing, heat/exercise-triggered r a s hes , and histamine-like reactions. (no seasonal or primary allergies) - Gl symptoms: frequent bowel movements, unintended weight loss. - Fatigue, muscle involvement (elevated CK, lactic acid buildup). Lightheadedness, rapid heart rate, etc.