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To the Editor:—
In the paper, " 'Constitutional' Allergic Reactions and Their Prevention," in The Journal, Oct. 31, page 1172, the author lists intradermal skin testing as one of the major causes of constitutional reactions. My experience in testing many children, in the last 20 years, in the Allergy Clinic of the Children's Hospital of Michigan and in private practice, is that constitutional reactions are extremely rare if preliminary screening tests are done by the scratch method.The author states, "It is fallacious to assume that preliminary scratch tests are a safeguard against constitutional reactions, which occur in spite of negative results of scratch tests, especially if the testing material employed by the scratch tests has lost its potency because it has been on hand too long." Experienced allergists do not make preliminary scratch tests with deteriorated materials. One must take exception to another statement in the paper, that infants and
Levin SJ. ALLERGIC REACTIONS. JAMA. 1960;172(5):479. doi:10.1001/jama.1960.03020050071028