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To the Editor:—
The sensitivity would have been established by scratch tests without the danger of systemic reaction. Subsequent to the initial systemic reaction, the patient was given small doses of penicillin G. These doses were sufficient to immunize the individual, and one would have predicted a rise in antibody titer had this been obtained. The second skin test at a concentration nine times the strength of the initial test, would, therefore, have been expected to give the reaction obtained.In addition to the above precautions, one should be additionally cautious on repeated skin tests. I have had the opportunity on several occasions to skin test individuals to both penicillin and insulin to find that initial skin tests were negative, but one month later the patient had significant positive intradermal reactions. In these situations the amount of antigen injected was sufficient to stimulate antibody production. Skin-test reactivity decreases following an
Condemi JJ. Penicilloyl-Polylysine Skin-Test Reactions. JAMA. 1966;197(3):226. doi:10.1001/jama.1966.03110030120053