Hypersensitivity to bacteria in eczema

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Abstract
Patients (7) with a macroscopic response resembling an Arthus reaction, and occurring 2-4 h after intracutaneous injections of staphylococcal particulate antigens or total staphylococcal extract, were examined for the appropriate specific antibodies that activate complement, and by immunofluorescence for antigen, immunoglobulin [Ig] and complement in the reaction site. Four patients had serum antibody and skin reactions with the typical features of early Arthus reactions; the skin contained Ig, complement and antigen. Three patients apparently had non-allergic responses. They lacked appropriate antibody in serum and Ig deposits in the lesions, although all except 1 had complement deposits in reaction sites. One of the 3 had histological changes typical of an Arthus response. Lymphocytes teased from the reaction site skin of 1 patient with a non-allergic 4 h response comprised 35 B [bone marrow-derived] cells bearing IgG of 200 counted. The nature of the non-allergic response reaching a maximum size at about 4 h macroscopically, and in some instances microscopically resembling an Arthus response, is still to be determined. This illustrates the caution necessary in interpretation of skin tests with bacterial antigens.

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