I have a patient on AIT who twice now has developed fluid-filled blisters in the area of her injection. Lesions appear the same day as the injection. First episode occurred a few months ago on her left arm, one blister that resorbed on its own. Had several more injections thereafter without reaction. Then last week developed 2 blisters on her right arm following her injection. She came to clinic today to show us, since one blister was still present a week later, and the other had ruptured with a brownish fluid. No other associated symptoms. The vial contains trees, grasses, weeds, and dust mite. My questions are:
1. Have you ever seen this before?
2. Should we be concerned that this could progress to a more severe cutaneous reaction if AIT is continued?
3. Would you discontinue AIT on this patient?