Delayed Hypersensitivity Skin Testing. I. Response Rates in a Hospitalized Population

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Abstract
Delayed cutaneous hypersensitivity was assessed in 752 hospitalized patients. Six antigens were injected intradermally and evaluated 48 hr later; stability of the reactions was tested again after one month. Reactivity rates to the antigens were: mumps, 68%; candida, 63%; trichophyton, 62%; tuberculin, 33%; histoplasmin, 26%; and coccidioidin, 13%. Half of all patients reacted concurrently to two of the first three antigens, 89% to at least one of the first three. Response to three of the four most reactive antigens must be evaluated to assess generalized cutaneous anergy. Histoplasmin and coccidioidin added < 1% to the total, and high degrees of concurrence suggested cross-reactivity between them. Erythema and induration were highly correlated for mumps, candida, and trichophyton, necessitating use of only induration for evaluation. Retesting of a small group of patients resulted in increased reactions with all antigens except tuberculin. Evaluation of possible tuberculosis is improved by simultaneous skin testing with several antigens.

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