Introduction: Erdheim-Chester Disease (ECD) is a rare non-Langerhans cell histiocytic disorder, first described in 1930. Its diverse manifestations range from asymptomatic bone lesions to severe systemic involvement. Herein, we report a novel case of ECD presenting with temporal bone pain, a symptom not previously described in the literature. Methods: We observed and analyzed the symptoms, clinical history, and imaging manifestations of a patient presenting with significant temporal bone pain. The diagnosis was confirmed via a biopsy. We also investigated the presence of the BRAFV600E mutation, which is known to be present in over half of ECD cases. Results: The patient presented with significant temporal bone pain on pressure but exhibited no clinical signs of urinary collapse or neurological symptoms. Imaging studies showed typical signs of ECD, and a biopsy confirmed the diagnosis. Genetic testing revealed the presence of the BRAFV600E mutation. Conclusion: This case extends our understanding of the clinical manifestations of ECD and highlights the potential for variable symptomatology. Temporal bone pain may be a novel presentation of ECD, emphasizing the need for a high index of suspicion and thorough evaluation in patients presenting with unexplained bone pain. The confirmation of the BRAFV600E mutation in this patient underlines its potential as a therapeutic target in ECD. Future research is necessary to fully elucidate the clinical significance and treatment implications of this novel presentation.

Background: The aim of this study is to investigate the impact of COVID-19 related treatment delay on subcutaneous immunotherapy (SCIT) efficacy in patients with allergic rhinitis (AR). Methods: The study was performed in 643 patients with SCIT appointments between February 1 and May 31, 2020. The clinical assessment, performed at baseline (V0) and one year later (V1), included visual analogue scale (VAS); daily symptom score (dSS); daily medication score (dMS); combined symptom and medication scores (CSMS); quality of life (QoL); self-rating anxiety scale (SAS); and self-rating depression scale (SDS) for each patient. Results: At V0, 249 patients were treated on schedule, and 394 were delayed (7 ± 4.68 weeks). Among them, 319 patients (105 on schedule, and 214 delayed) also completed the assessments at V1, with the absence of 25.39% patients due to completion of SCIT, and 25.35% patients were withdrawal. The results of all assessments were within the normal range for all patients at V0 and V1, with the exception of a slightly higher SDS score (56.13) at V0. In the SCIT delayed group. there was a significant positive correlation between the length (weeks) of the delay and SDS score, and this was significantly higher in patients with poor control of nasal symptoms. Conclusions: This study showed the long-term efficacy of SCIT for AR patients, including those who have had to delay normal therapy due to the COVID-19 outbreak. The psychological status of SCIT patients in response to lockdown of hospital services during this critical period should be considered.