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Background: We evaluated the value of positive intradermal dilution testing (IDT) after negative skin prick tests (SPT) by retrospectively determining allergy immunotherapy (AIT) outcomes., Methods: This private practice, cohort study compared the relative value of SPT vs. IDT in 371 adults and children with suspected manifestations of allergy: chronic allergic rhinitis (AR), asthma and/or chronic otitis media with effusion (OME). The primary outcome measure was symptom resolution following immunotherapy, as determined by symptom severity questionnaires completed by patients before and after AIT., Results: Positive IDT identified 193 (52%) patients who would not otherwise have been diagnosed. IDT detected 3.7-fold more allergens per patient than SPT (8.56 vs. 2.3; p < 0.01). Patients positive only on IDT responded to AIT equally well as those identifiable by SPT, independent of allergen sensitivity (67% by SPT vs. 62% by IDT; p = 0.69, not significantly different)., Conclusion: Intradermal titration can identify patients who will benefit from allergy immunotherapy more accurately than SPT. Outcomes analysis in 371 patients shows that IDT doubled their chance of successful treatment with no greater risk of therapeutic failure. Positive IDT, following negative SPT, is clinically relevant and offers superior sensitivity over SPT for detecting allergens clinically relevant to diagnosis of AIT-responsive atopic disease.

Background: Tests for allergen-specific immunoglobulin E (IgE) are used to select allergens for immunotherapy in atopic dogs. Antibodies against cross-reactive carbohydrate determinants (anti-CCD IgE) have been identified in serum samples of atopic dogs. Their presence in humans is a known cause of clinically irrelevant polysensitization to plant allergens., Objectives: To compare the results of an intradermal test (IDT) and a serum test for allergen-specific IgE, with and without blocking anti-CCD IgE, before testing in dogs., Animals: Thirty-one privately owned dogs with atopic dermatitis., Methods and Materials: Dogs were prospectively skin tested and their serum samples were analysed for anti-CCD IgE. An Fc-ε receptor-based serum test for allergen-specific IgE was performed with and without blocking anti-CCD IgE., Results: In dogs with negative anti-CCD IgE samples, the agreement between the results of the serum test and the IDT was substantial (κ = 0.71). Dogs with positive anti-CCD IgE samples (38.7%) showed no agreement between serum and skin testing (κ = -0.35), blocking anti-CCD IgE in those samples resulted in a fair agreement (κ = 0.43). Anti-CCD IgE positive sera had multiple positive results for grass and weed allergens, and blocking decreased them markedly., Conclusion and Clinical Importance: Intradermal testing agreed best with serum testing in dogs with no detectable anti-CCD IgE. Sera containing anti-CCD IgE had no agreement with IDT. Test agreement was improved by blocking the anti-CCD IgE. Apparent serum test polysensitization to plant allergens was associated with anti-CCD IgE., (© 2019 ESVD and ACVD.)

Background: Topical therapy is preferred for otitis externa (OE) in dogs. Otic products commonly contain glucocorticoids that can be systemically absorbed and possibly interfere with diagnostic tests such as intradermal testing (IDT)., Hypothesis/objectives: To determine the effect of a long-lasting otic solution containing mometasone furoate (MF) on IDT immediate reactions and to determine withdrawal time before IDT., Animals: Seventeen dogs with healthy ears (Group 1) and 12 with OE (Group 2)., Materials and Methods: Intradermal injections of histamine, anticanine-immunoglobulin (Ig)E and saline were subjectively and objectively evaluated before treatment and weekly for 6 weeks, after a single application of a long-lasting otic solution containing MF., Results: Statistically significant reductions in the mean subjective histamine scores after application of MF were observed at Weeks 1 (p = 0.012) and 2 (p = 0.028) in Group 1, and Weeks 1 (p = 0.00066), 2 (p = 0.02) and 4 (p = 0.034) in Group 2. Mean histamine objective scores were significantly reduced in Weeks 1 (p = 0.042), 2 (p = 0.0009), 3 (p = 0.001) and 5 (p = 0.018) in Group 1 only. The mean subjective anticanine-IgE scores were significantly reduced in Week 1 in both groups (p = 0.003, p = 0.0066), respectively. There were no significant changes in the mean anticanine-IgE objective score in either group., Conclusions and Clinical Relevance: Application of a long-lasting otic solution containing MF can interfere with IDT immediate reactions in healthy and OE dogs. Based on the subjective evaluation, IDT can be performed ≥2 weeks after application of the otic solution in healthy dogs, and ≥4 weeks in dogs with OE., (© 2024 The Author(s). Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of ESVD and ACVD.)

Background: Limited information exists about the correlation between clinical history and positive serum (SAT) and intradermal allergen test (IDAT) results in atopic dogs., Objectives: To evaluate the correlation between clinical history and SAT/IDAT results in atopic dogs., Animals: Twenty-nine client-owned dogs with nonseasonal atopic dermatitis with or without seasonal exacerbation were enrolled., Materials and Methods: IDAT, SAT (immunoglobulin (Ig)M antibody capture enzyme-linked immunosorbent assay [MacELISA] with bromelain CCD inhibitor) and clinical information collected in a questionnaire regarding seasonal variations in pruritus affecting the dogs were performed on the same day. Two independent investigators (Inv A and Inv B) recorded IDAT results., Results: The kappa coefficients agreement for positive IDAT scores between Inv A and B was substantial. The agreement between IDAT and SAT results at different ELISA absorbance units (EAU) cut-offs (>79 and ≥300) was slight and fair for both investigators, respectively. A higher agreement was observed between IDAT and SAT (≥300 EAU) than between IDAT and SAT (>79 EAU) with the exception of mite and flea allergens. There was a statistically significant association between clinical history and positive IDAT results for seasonal allergens (Inv A and Inv B, p = 0.016). There was no significance between positive SAT results and clinical history. Five (IDAT) and 12 of 13 (SAT) atopic dogs without clinical seasonal exacerbation showed positive results for seasonal allergens., Conclusions and Clinical Relevance: The agreement between IDAT and SAT ≥300 EAU results was fair and the agreement between IDAT and SAT >79 EAU results was slight for all allergens. Only positive IDAT results significantly correlated with clinical history., (© 2024 ESVD and ACVD.)

Background: Topical ear medications, often containing a glucocorticoid, are used to treat the clinical signs of atopic otitis in dogs. Studies have looked at the inhibitory effect of topical glucocorticoids on intradermal testing (IDT), but only one previously published study evaluated the influence of an otic glucocorticoid on the results of IDT in dogs., Hypothesis/objectives: To assess what influence the absorption of the diester glucocorticoid mometasone furoate (MF) had on intradermal test immediate reactions, to determine an appropriate withdrawal time prior to IDT., Methods: Twenty atopic dogs were enrolled. On day 0, histamine, rabbit anticanine IgE antiserum and saline were injected intradermally. After 20 min, a global wheal score (GWS) was determined. The otic medication, MF, was applied once daily for 14 days. Intradermal injections were then repeated and, if the GWS was within 25% of pretreatment values, the study was completed for this dog. If the GWS had decreased by ≥25% from the baseline value, the otic medication was withdrawn, and the GWS was repeated every 7 days until its value was within 25% of the original GWS., Results: Three of the 20 dogs completed the study on day 14, while 17 of 20 dogs ended it on day 21, 7 days after withdrawal of the drug, MF., Conclusions and Clinical Importance: Results from this study show that a withdrawal period of ≤7 days is possible before performing IDT in atopic dogs with active otitis externa treated with ≤14 days of MF., (© 2014 ESVD and ACVD.)

A 5 year-old boy experienced anaphylaxis after eating a jelly product for diet supplement containing erythritol as a major component. Prick test with the jelly product was negative, but the second oral ingestion of the jelly product at home caused another allergic reaction. Prick test with erythritol was negative even at 300 mg/ml, which was almost the solubility limit. Intradermal test was marginally positive at 0.1 mg/ml, and clearly positive at 1 mg/ml or higher concentration. We found subtle dose-response reaction utilizing basophil activation test, examined with 24 hour incubation at the concentration of 40-4000 μg/ml. At the oral challenge test in the hospital, 3 g of erythritol induced remarkable coughing, urticaria, edema, wheezing and hypoxemia. Erythritol is a natural sugar alcohol, with the molecular weight of 122.12, which is recently being widely used for diet supplements, beverages, or drug medicines due to its properties of calorie-free and good-tasting, with easy-to-use physical characteristics. We now have to recognize erythritol as a candidate for food allergen, and to be careful about negative result of prick test.

Epidemiological studies of paracoccidioidomycosis have been based on surveys achieved with intradermal tests, and paracoccidioidin is the most common antigen used in most cases. The glycoprotein of 43-kDa (gp43) has been used in intradermal tests. It is the most antigenic component of Paracoccidioides brasiliensis, and it provides greater specificity to evaluate infection for this fungus. In this study, the prevalence of P. brasiliensis infection was estimated with intradermal tests involving gp43 for 695 people in rural Central-West Brazil. The infection rate was 45.8 % (95 % CI = 42.1-49.5), and the average age of those infected was 45.8 ± 18.2 years. The prevalence did not show gender-based differences but increased with age. The results demonstrate the importance of P. brasiliensis infection in rural settlements and the early exposure of children in the region to the fungus. Despite the high antigenicity and specificity of gp43, its usage must be standardized, so that epidemiological surveys will be comparable and more accurately reflect P. brasiliensis infection in endemic areas.

The intradermal tuberculin tests and the interferon-gamma (IFN-γ) assay are the principal tests used worldwide for the ante-mortem diagnosis of bovine tuberculosis. The conventional reagent currently in use in these tests is purified protein derivative (PPD) tuberculin obtained from Mycobacterium bovis culture. The components of PPD are poorly characterized and difficult to standardize. To overcome this issue, antigens specific to the Mycobacterium tuberculosis complex are being studied. Here we have assessed the biological potency of ESAT-6, CFP-10 and Rv-3615c presented as peptide or recombinant protein cocktails in comparison with the standard bovine PPD used routinely in Spanish eradication campaigns. The study was performed in cattle (n=23) from a herd with natural M. bovis infection. Animals were simultaneously injected with PPD and the peptide and protein cocktails. The percentages of cattle reacting positively to single intradermal test were 60.9% (bovine PPD), 47.8% (peptide cocktail) and 60.9% (protein cocktail), with no significant difference between the actual skin fold thickness increases (p>0.05). The IFN-γ assay detected 60.9% of animals when stimulation was performed with bovine PPD, but decreased to 52.2% when stimulation was performed with the peptide cocktail and to 47.8% when stimulation was performed with the protein cocktail. However, no significant differences were found between IFN-γ responder frequencies (p>0.05). These results show a potential use of these defined reagents for in vivo tuberculosis diagnosis., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The neutralising antibody response after the yellow fever vaccine (YF-17D) skin test was measured in 7 egg allergic persons in whom further vaccination was abandoned because of a strong local urticarial reaction to the YF-17D vaccine test dose. We found that this test dose of 0.1mL of YF-17D vaccine was sufficient to induce a protective antibody response in all 7 subjects. Intradermal injection of 1/5th dose of the yellow fever vaccine appears to be sufficient, in non-allergic as well as allergic persons, and non-inferior to the subcutaneous full dose.

Background: Metamizole is a pyrazolone derivative, and its most common reactions are IgE-mediated reaction and idiosyncratic reactions. Non-immediate reactions are poorly described and there are very few reports on non-immediate reactions to pyrazolones., Materials and Methods: We evaluated 12 patients (nine men) who consulted for a non-immediate reaction after metamizol administration. We performed cutaneous tests (skin prick tests and immediate and delayed intradermal tests) and epicutaneous tests, and, if necessary, an oral challenge test., Results: All skin prick and intradermal tests, if necessary, were negative in immediate reading. Delayed intradermal tests were positive in six of 10 patients (60%) and epicutaneous tests were positive in four of 11 patients (36%). Three cases (25%), were diagnosed by a positive oral challenge test., Discussion: Delayed-reading intradermal tests and patch tests are useful tools in the diagnosis of nonimmediate reactions to pyrazolones and should be considered the first step when evaluating these type of reactions. Intradermal test appears to be more sensitive than patch test. The positivity of skin tests suggests an immunological reaction, probably mediated by T lymphocytes, but further studies are required.

Objective: The purpose of this study was to evaluate concurrent positive reactions of related versus nonrelated allergens based on 1000 intradermal tests of dogs with atopic dermatitis., Procedure: Pairs of closely related allergens (based on botanical relations and results of research in human allergic disease) and nonrelated allergens were evaluated. Significance of the difference between group means of log odds ratios was estimated using a Bootstrap percentile confidence interval., Results: There was a significant difference in the mean log odds ratio between related and nonrelated allergen pairs. However, there was also a significant difference between most groups consisting of nonrelated allergen pairs., Conclusion: These results provide conflicting evidence and emphasise the need for further studies. Numbers of concurrent reactions of related allergens indicate that immunotherapy should be formulated based on testing with single allergens to avoid exposure to allergens not involved in the dog's atopic disease.

Background/aims: The diagnosis of clonorchiasis is based on demonstrating eggs in stool or bile. It is believed that bile examination is the most precise method for detecting eggs. We evaluated diagnostic usefulness of intradermal test (IDT) by comparing it with the result of bile examination., Methods: For 88 patients with pancreatobiliary diseases, we examined Clonorchis sinensis eggs in bile and performed IDT for clonorchiasis. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes., Results: We calculated ROC curve to decide the cut-off value of IDT in determining diagnostic accuracy on the basis of bile examination. We chose a value of 40 mm2, which significantly improved the sensitivity, without reducing the specificity. With a cut-off value of 40 mm2, the sensitivity, specificity, positive and negative predictive values of IDT were 81.5%, 67.2%, 52.4%, and 89.1%, respectively. The value of IDT was not affected by age and showed no difference between benign and malignant diseases. However, in egg-positive patients, the mean value was lower in malignant diseases than in benign diseases., Conclusions: In patients with pancreatobiliary diseases, IDT with a cut-off value of 40 mm2 seems to be a valuable supplementary diagnostic test for clonorchiasis in view of its high sensitivity.

We compared the effect of propofol and saline control on intradermal test reactions in dogs with atopic dermatitis undergoing outpatient intradermal testing (IDT). Nineteen dogs were used in this clinical study. Patients were randomly allocated to receive either intravenous (IV) propofol or IV 0.9% saline, and IDT was performed on the right or left (randomized) lateral thorax. One investigator, unaware of the treatments, interpreted all IDT results. Injection sites were analysed using a subjective and objective method. A value of P or= 1+ on all dogs, significantly more positive sites were apparent during propofol sedation than during saline administration. In addition, the greater number of individual dogs experiencing more positive reactions >or= 1+ during propofol sedation was significant. When subjectively analysing reactions >or= 2+, the greater number of positive reactions and the greater number of dogs with more positive reactions observed during propofol treatment was not significantly different from the saline control. When analysed objectively, the greater number of positive reactions observed during propofol sedation was not significant. A greater number of dogs had higher subjective scores and larger objective measurements during propofol sedation compared with saline administration. In summary, propofol sedation was associated with an overall greater number of positive IDT reactions compared with the saline control. Although not always significant, this difference should be considered when choosing propofol for skin testing dogs with atopic dermatitis.

Investigations concerning an intradermal test for the diagnosis of BHV 1 infection were carried out in 221 cattle. In 16% of cases the result of the test was dependent on the time the test was read (48 or 72 h). Fifteen per cent of the animals older than 9 months showed no reaction to the intradermal test though humoral antibodies against BHV 1 were detectable by ELISA. Intradermal injection of test antigen resulted in seroconversion in seronegative cattle. The antibodies remained detectable in the ELISA for about 3 to 6 weeks.

An intradermal (ID) test (a delayed-type hypersensitivity test) was used for the diagnosis of BHV-1 infection in cattle. A threshold value for the test positive results was established based on the analysis of the agreement between the results of ID test and those of virus neutralization (VN24) assay. Linear regression analysis revealed no correlation between the intensity of the skin reaction (expressed as an increase in skin-fold thickness) and the VN24 antibody titre. The sensitivity and specificity of the ID test compared to VN24 one, were 86.6% and 98.3% respectively. Of the 487 cattle with an age of over 6 months, 25 (5.1%) reacted discordantly by ID and VN24 tests, i.e. 19 seropositive animals expressed little or no skin reaction, whereas 6 seronegative individuals were positive by ID. Neither of the calves, with passively acquired antibodies in contrast to experimentally infected ones, showed distinctive skin reaction.

The effect of the repeated delayed-type hypersensitivity (DTH) testing (an intradermal test--ID) on virus neutralizing (VN) antibody and DTH responses has been studied. Repeated intradermal injection of inactivated BHV-1 antigen elicited neither the virus neutralizing antibody nor positive skin reaction in cattle free from BHV-1 infection. On the other, hand, the same manipulation carried out in a herd infected with BHV-1 provoked seroconversion and/or positive DTH reaction in some of the animals without detectable pre-existing VN antibody. Cattle initially positive by VN and intradermal tests showed steady increase in antibody titre, and some of them developed little or no skin reaction following repeated DTH testing.

An intradermal test for the diagnosis of BHV 1 (Intrakutantest Behringwerke AG) was applied to 53 nonvaccinated BHV 1-seronegative cattle aged 7 months to 8 years. Serologic blood testing performed subsequently using ELISA (Enzygnost-IBR/IPV, Behringwerke AG) and SNT revealed seroconversion in 24 of 45 animals without previous maternal antibodies. A second application of the intradermal test after these BHV 1-antibodies had declined, lead to a 'booster-effect' while a control group remained negative. Six of nine animals not affected by the first intradermal application of BHV 1-antigen, developed BHV 1-antibodies following the second intradermal test. Eight animals possessing maternal antibodies showed no serological response to the intradermal test at all. Present results strongly suggest an induction of humoral BHV 1-antibodies by the intradermal application of inactivated BHV 1. Consequently, the indirect control of BHV 1 infections, especially in cattle breeding farms, should be done exclusively by serological examination.

Chironomidea (Insecta) is recently considered one of the most common inhalant antigen in Japan. Intradermal tests with Chironomus plumosus (CP) extract were undertaken on seven hundred and eighteen asthmatic children aged from 6 to 15 years in 10 areas (11 medical institutions) in Japan. The number of cases who showed positive intradermal tests with CP extract was 200 (27.9%) and the positive rate increased in proportion to their age (p less than 0.005). In each of the 11 medical institutions the positive rates ranged from 12.6% in Akita to 45.5% in Okinawa. There were no significant correlations between the results of the intradermal test with CP and those of RAST, prick test and intradermal test with mite, HD and silk, whereas correlation was noted in the prick test with silk (p less than 0.01). The CP positive asthmatics had significantly more attacks than the CP negative ones in the summer (p less than 0.01). The positive rate of asthmatics living near paddy or farm fields was significantly higher than that of those in urban residential areas (31.3% vs 23.8%, p less than 0.05). Chironomid midge is one of the most common and important allergen in Japan.

In systemic photosensitivity to drugs, the modified irradiated intradermal assay is a valuable diagnostic tool. We discuss its advantages in comparison to both the less sensitive photopatch and the potentially dangerous and/or bothersome technique of systemic photochallenge.

A purified concentrated BHV1 antigen that had been tested in field trials was also tested under isolated conditions in BHV1 positive and negative cattle. The antigen proved to act specifically even after storage for 2 years at +4 degrees C or for 6 months at 37 degrees C. The best results were obtained when the test was read 48-72 hours after the injection, which is in agreement with the field trials. The increase in skin thickness decreased unless boosted by infection or vaccination gradually. The test is unsuitable to control a vaccination programme. There was no correlation between the increase in thickness and humoral antibody titers. Repeated application of the intradermal injection of the antigen did not result in seroconversion in seronegative cattle. The biological limits of the test evaluation are discussed.

Background: Intradermal testing (IDT) with iodinated contrast media (ICMs) is an established diagnostic tool in patients with ICM hypersensitivity. Currently, it is unclear which test concentration is the more useful one, up to pure or up to 1:10 diluted ICMs., Methods: We searched the literature database PubMed for eligible papers dealing with ICM allergy and their IDT results. We analyzed the data presented by the papers and compared the pooled groups tested with diluted and undiluted ICMs., Results: We identified 29 eligible original papers, and extracted data of 1137 patients that formed the study population. Although in the cohort tested with diluted ICMs the number of tested ICMs was greater, the percentage of positive tests was significantly less (9.0% vs. 24.7%; P < 0.0001; OR 0.30 [0.26-0.34]). The frequency of positive tested culprit ICMs was also lesser in the group tested with diluted ICMs (31.0% vs. 72.5%; P < 0.0001; OR 0.17 [0.12-0.23]). The number of drug provocation tests (DPTs) was greater in patients with diluted IDTs (374 vs. 89; P < 0.0001; OR 2.54 [1.93-3.36]). We detected an increased sensitivity in patients with undiluted tests (0.774 vs. 0.282) and a nearly identical specificity in both groups (1 vs. 0.983)., Conclusions: For the first time, we show that IDT up to pure ICM concentrations is superior to using diluted ICMs only. Possibly, we can reduce the number of DPTs when performing IDTs with pure ICMs. In the undiluted group, there were no hints for skin irritations or unspecific test reactions., (© 2024 The Authors. Fundamental & Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of Société Française de Pharmacologie et de Thérapeutique.)

A partially purified Echinococcus antigen solution, prepared by boiling hydatid cyst fluid, was used in the intradermal test for hydatid disease in a Peruvian population. An unexpectedly high rate of positive reactions and poor agreement with serological tests suggested the presence of some agent(s) which produced cross-reactions with Echinococcus granulosus antigens in the intradermal test. Testing of hospital patients infected with a variety of helminths demonstrated nonspecific reactions in persons with Hymenolepis nana, Taenia spp., and Fasciola hepatica infections, mixed parasitisms, and several non-helminth pathological conditions. The findings contraindicated the use of the intradermal test for epidemiological surveys of hydatid disease. It is pointed out that intradermal test positivity rates cannot be used as synonymous with infection prevalence and regional differences do not necessarily reflect differences in the prevalence of E. granulosus infection. The greater specificity of some serological tests favor their use for epidemiological purposes.

The capacity of tegobetain, pyrrolnitrin, tolcyclate and chlorquinaldol to induce delayed-type contact sensitization was studied in guinea pigs in 2 series of tests using the method of Magnusson & Kligman and the authors' modification of the wholly intradermal Draize technique. Histological examination of skin biopsies obtained from the test area demonstrated that tegobetain, pyrrolnitrin and tolcyclate are potential sensitizers.

To compare two different sources of bird-antigens (intestinal extracts versus serum dilutions) we performed intracutaneous tests in 79 birdkeepers (34 pigeon-, 20 hen- and 25 budgerigar-keepers) and in nonexposed control persons. The bird-exposed persons were divided into 3 groups: 1. Seropositive patients with extrinsic allergic alveolitis (EAA), 2. seropositive persons without any signs of EAA (sensitized asymptomatics), and 3. exposed seronegative healthy persons. The results of the investigation demonstrate that the early skin-reaction (20 minutes after antigen-application) is nonspecific and do not have any diagnostic value. Most of patients with EAA (65.7%) and 29.6% of sensitized asymptomatics developed a positive 6-hour-(Arthus-) reaction with intestinal extracts, whereas in control groups we have not seen any Arthus reaction. Consequently, we recommend the use of intestinal extracts in the diagnostic procedure of EAA.

An intradermal test (delayed hypersensitivity test) for the diagnosis of BHV1 infection was evaluated in 791 cattle of 16 dairy farms. The skin reactions were compared with the results of serological examinations using a commercial BHV1 ELISA kit (Trachitest). As antigen concentrated, purified and inactivated BHV1 was used. The skin reaction (increase of the skin fold thickness) was used for the interpretation of test results. The best results were obtained with the control of the skin reaction on the third day after injection of the antigen. From 393 serologically BHV1 negative cattle with an age of more than 6 months 391 (99.5%) had a skin reaction up to 1.0 mm and 2 animals (0.5%) had a reaction of 1.3 and 1.9 mm, respectively. The mean increase of skin fold thickness was 0.2 mm. Out of 291 serologically BHV1 positive cattle with an age of more than 6 months 270 had antibodies from natural infection and, partially, from additional vaccination with inactivated BHV1 vaccine. 266 (98.5%) of these animals showed a skin reaction of more than 2.0 mm, in 3 animals (1.1%) a skin reaction up to 1.0 mm was observed and 1 animal (0.4%) had a reaction of 2.0 mm. The mean increase of the skin fold thickness was 6.3 mm. 21 animals had BHV1 antibodies only because of vaccination with inactivated BHV1 vaccine. Only 4 animals had a skin reaction of more than 2.0 mm. Among 107 animals with an age up to 6 months 30 were serologically BHV1 positive and 77 were BHV1 negative. In all animals the skin reaction was less than 1.0 mm, the mean was 0.2 mm.

The percentage of strongly positive reactions to intradermal testing of 2,997 pregnant women was found to grown continuously by about one per cent per annum along with growing age. -- The conclusion drawn from comprehensive discussion of the above findings is that cellular immunity is likely to grow rather than decline, as assumed in the past, following toxoplasmosis infection. However, the increase, about one per cent annually, is of minor dimensions and might be based on a booster effect. -- This would mean, after all, that the intradermal test will continue to be of informative value, even long time after the infection, for example, in the context of aged patients. Therefore, no correction is required either by the criteria of interpretation.

A clinical study to evaluate the Makari Intradermal Test (MIT) involved 180 patients seen with symptoms suggestive of malignant disease, 85 of whom were subsequently shown to have carcinoma of the large bowel, and 66 asymptomatic volunteers. The prognostic value of initial and serial studies relative to patient-survival rate and the efficacy of serial studies in detecting disease in long-term follow-up of patients with resected malignant lesions were evaluated. On the basis of this study, the MIT appears to merit further investigation, not as a definitive diagnostic procedure, but as a survey for identifying patients with early malignancy or individuals at high risk to malignant epigenesis.

The intradermal test in mice is a valuable model for assessing dermal tolerance to chemical substances. The test material is administered intracutaneously to hairless or depilated mice through a fine syringe, the animals are killed after 24 hours and the treated skin is removed, dried and assessed for reaction area, erythema and oedema. The skin fragments can be preserved as a record of the findings. While direct transfer of the findings from mouse to man is likely to be misleading, the test is well suited to comparative studies. Moreover it requires only small numbers of mice.

RAST and intradermal testing correlated reasonably well for untreated patients for ragweed and molds and in treated patients for trees. Capillary blood was found to be comparable to venous blood as a source for RAST for ragweed and mixed grasses.

Reference is made to an earlier study into the usefulness of the intradermal test. Now, an account is given of the specificities of tests used at present for the detection of toxoplasmosis, with reference being made to 4,341 intradermal tests, 1,332 dye tests, and 880 complement fixations. -- The three methods are qualitatively and quantitatively compared in great detail, with the close correlations between them explained. Reference is also made to the different origins of the antibody types detectable by the methods concerned. -- It seems to be quite obvious that the production of those antibody types differs in time and site, just as their lives are different in length. These findings actually are used as a point of departure for more detailed methodical proposals that should be followed in the search for an acute infection with Toxoplasma gondii. -- Various effects which might lead to unspecific tests are described in some length. -- All the above studies and findings have been used to compile a diagnosis diagram which may be a good basis for clinical decision-making on therapy.

An intradermal test was developed to screen cattle for infection with the first-instar larvae of the warble flies Hypoderma lineatum and H. bovis. The diagnostic antigen, prepared from the first-instar larvae of H. lineatum, produced a distinct dermal reaction in cattle infected with the first-instar larvae of either species, but not in cattle in which the infection could not be confirmed later either on necropsy or by the appearance of warbles in the back. The reaction to the antigen was unpredictable in cattle with warbles in their backs. The diagnostic property of the antigen was also demonstrated in rabbits and guinea pigs artificially sensitized to the antigen.

Variations of intradermal test results were studied in a group of patients with clinically evident contact dermatitis and with the history suggestive of contact with metals and with negative patch tests reactions to the latter. The positive reactions obtained in several cases indicate that intradermal tests may reveal specific sensitivities, which patch tests using standard concentrations are not always capable of demonstrating.

A group of 143 dogs and cats with pruritic skin disease was tested by intradermal injection of a dilute whole cat flea extract. The test results were correlated with the clinical diagnosis (Table I, III), with previous or present findings of fleas on the animals (Table II, III), with the presence or absence of blood eosinophilia (Table IV), and, in animals with clinical flea allergy, with the histological findings in a skin biopsy excised from a clinically affected skin site (Fig. 1). The predictive value of a positive and a negative outcome of the test was assessed graphically by means of calculations described in the Appendix (Figs. 2, 3). It is concluded that the test is sufficiently specific to justify its use in animals where flea allergy is suspected but cannot be proved by routine clinical examination. The histological findings and the nature of the skin reactions suggest that a positive outcome of the test is indicative of an immediate, type I hypersensitivity towards components of the oral secretion of fleas and that this hypersensitivity is mediated by reaginic antibody which to some extent is produced by plasma cells located in skin areas where flea saliva is deposited.