Skin tests reagents

Solley GO, Gleich GJ, Van Dellen RG. Penicillin allergy clinical experience with a battery of skin-test reagents. J Allergy Qin Immunol 1982 69(2) 238-44. 

Allergic recognition by some patients of side chain determinants highlights the importance of including different individual peniciUins in the battery of penicillin skin test reagents. 

Many materials in concentrated forms, whether to be used in food or as test reagents, are a skin or respiratory irritant or are otherwise toxic. Use caution when handling these materials. 

Macy E, Richter PK, Falkoff R, Zeiger R. Skin testing with penicUloate and penilloate prepared by an improved method amoxicillin oral challenge in patients with negative skin test responses to penicillin reagents. J Allergy ain Immunol 1997 100(5) 586-91. 

Results as shown in Table 5 demonstrate that testing with penicilloyl-polylysine yields a high percentage of positive skin tests in the early stage following the reaction, whereas results obtained with benzylpenicillin (BPN) are much lower, which sems to demonstrate that different determinants are involved. This is confirmed by the observation that onyl one-third of these patients react positively to both reagents. 

A more systematic use of reagents carrying some of the other structural determinants described below might reveals a different picture. Recent work by Assem and Vickers (1975) and by Edwards et al. (1982) has indicated the possibility that the penicillamine and penicillanyl determinants may be more frequently involved than hitherto realized. The relatively high frequency of positive skin tests to a penicillamine-polylysine conjugate in patients allergic to penicillins (Schneider et al. 1973) points to the same conclusion. 

Uses Intermediate for chemical synthesis test reagent for analysis of fiber mfg. pharmaceuticals, medicines (removal of skin lesions as a disinfectant)... 

Immunologic The contribution of skin tests with penicilloyl-polylysine and the minor determinant mixture to the diagnosis of non-immediate reactions to penicillins have been evaluated in 162 adults who had had 232 non-immediate reactions to penicillins, mostly aminopenicillins, and had positive skin and/or patch tests to one or more penicillin reagents penicilloyl-polylysine,... 

The question of tolerability of penicillins, monobactams, and carbapenems in patients with IgE hypersensitivity to cephalosporins was recently assessed in 98 subjects by serum IgE antibody assays, challenge tests, and skin testing with penicillin reagents, aztreonam, imipenem-cilastatin, and meropenem. Approximately 25 % of cephalosporin-allergic subjects were positive to penicillins, while 3.1,2, and 1 % showed positive results to aztreonam, imipenem, and meropenem, respectively. A reaction to a cephalosporin with a similar or identical side chain to penicillin was a sigifificant predictor of cross-reactivity. For skin testing, the following concentrations were used ampicillin and amoxicillin 1 and 20 mg/ml cephalosporins 2 mg/ml aztreonam 2 mg/ml imipenem-cilastatin 0.5 mg/ml and meropenem 1 mg/ml. 

All color test reagents (except C) must be handled with care and should not come into contact with skin, herbarium envelopes, etc. If spilled, PD can be (incompletely) removed by washing with very dilute acetic or hydrochloric acid. 

The MDM contains penicillin, benzylpenicilloate, benzylpenllloate and benzylpenicllloylamine. These simple chemicals are presumed to elicit the minor-determinant test by reacting with soluble proteins in the skin test site to form the proper multivalent hapten elicitors. Although MDM is apparently an effective test reagent, little Is clearly known about how it elicits positive skin tests. 

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