We report a 13 year-old boy received sibling matched allogeneic hematopoietic cell transplantation (HCT) due to T-cell acute lymphoblastic leukemia (ALL). His immediate post-HCT course was uneventful except mild diarrhea and skin rash on the face and neck which appeared on post-HCT day +7. He was on cyclosporine for graft versus host diseases (GVHD) prophylaxis. His skin rashes were waxing and waning without any improvement. On day +21, skin rash spread to upper trunk. He started to complain of intense pruritis which aggravated especially at night. A skin biopsy was performed on day +28. A skin biopsy was performed on day +28 and the result showed suspected skin GVHD. His extensive itchiness did not improved despite multiple treatment intervention using antihistamine, steroid, gabapetin and lorazepam along with the control of cyclosporine dosage. Although he complained of massive itchiness, the skin lesions were relatively mild. The patient was on cefazolin for skin lesions caused by from aggressive scratch. On day +40, his mother and grandmother also started to have small papular rashes with itching sense on hands and arms. At this point, infectious diseases consultation was requested for evaluation of the skin rash and modification of antibiotic management.