Penicilloyl-Polylysine Skin Test:

THE PRESENT report documents the view that intradermal skin testing with the synthetic polyfunctional hapten of penicillin, ie, penicilloylpolylysine (PPL), poses the hazard of anaphylaxis. In addition, it illustrates the fact that antigen specificity may remain in such a narrow band that the PPL skin test fails to indicate what the patient's reaction to penicillin G may be. Admittedly unusual, the following experience has been extracted from our investigations of adverse drug reactions. 1 Report of a Case This 30-year-old, healthy, white man gave a history of having developed a delayed papular eruption following potassium penicillin G therapy six years ago. Treatment with penicillin had been avoided in the interim. The following observations were made: Absolute circulating basophil count was 29/cu mm (normal range = 20 to 50). Results from a penicillin G direct basophil test 2 (dilution 1/600) were negative. Results from the penicillin G histamine release test (indirect rabbit)