An 18-year-old female patient has been diagnosed with asthma, allergic rhinitis and AD since childhood. The patient, whose asthma was under control, was using nasal antihistamine, nasal steroid and oral levocetirizine + montelukast combination for allergic rhinitis.

In the skin prick test (SPT) of the patient, who did not have any features in the physical examination, sensitivity to mite, grass pollen, dog, rye was detected.It was decided to start subcutaneous allergen-specific immunotherapy for grass pollen and house dust mite before the season, for the patient who did not want to use drugs for a long time.In blood tests performed before treatment, hemogram, kidney and liver function tests were normal. Total IgE: 1078 IU/ml, specific IgE (D1 ptero): 42.7 KU/L, specific IgE (D2 farin): 77.1 KU/L.Allergen-specific immunotherapy was initiated for grass pollen and house dust mite before the season in accordance with the simultaneous cluster dose scheme. For pollen, 0.1 ml was injected from bottle A (1,000 TU/ml), and for house dust mite 0.7 ml was injected from bottle no. 1 (50 TU/ml).

A day or two after the first injection, the patient started with widespread redness, itching and burning complaints on the face and cheeks, and within a week, dry lesions occurred on the face of the patient (Figure 1).The patient’s complaint of atopic dermatitis increased and the lesions were thought to be infected.AIT was stopped. The patient was consulted with dermatology. Anti-HSV Type 1 IgM was found positive in the blood test, and IgG was negative.There was no growth in the wound swab culture. With the diagnosis of eczema herpeticum, amoxicillin+clavulanic acid 1000 mg 2*1 oral, acyclovir 250 mg 3*1 iv, acyclovir topical treatment was started and completed in 10 days. Skin lesions gradually regressed in the patient’s follow-ups.The lesions disappeared completely after about 1 month (Figure 2). AIT was not repeated for allergic rhinitis, medical treatment was continued.