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Recent Advances in the Understanding of the Penicillin Urticarias
OTIS F. JILLSON, MD;
PAUL S. PORTER, MD
Arch Dermatol. 1965;92(2):200-204.
Abstract
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The three major groups of immunoglobulins ( G, A, and M) associated with this disease are reviewed. The presence or absence of atopic disease may account for percentage variability of A because reagins (skin-sensitizing antibodies) are found in this immunoglobulin. The A is the antibody usually responsible for anaphylaxis, rather than the G precipitins, so stressed in the past. All three immunoglobulins may be found in serum sickness, which could account for the complex nature of this type of penicillin urticaria.
The merits of the immunological tests (penicilloyl-polylysine, benzyl penicillin, hemagglutination, basophil degranulation) for the detection of penicillin sensitivity are analyzed, partcularly as each applies to the various types of penicillin urticaria (serum sickness, anaphylactic, dermographic, delayed dermographic, and simple chronic urticaria and the lupus diathesis). The penicilloyl-polylysine test is greatly overrated as a means of predicting possible anaphylaxis. The benzyl penicillin skin test properly performed is an excellent means of indicating this.
Author Affiliations
HANOVER, NH
From the Department of Dermatology, Dartmouth Medical School, and the Department of Dermatology, Hitchcock Clinic, Hanover, NH. Associate Professor of Dermatology, Dartmouth Medical School (Dr. Jillson); Resident in Dermatology, Hitchcock Clinic (Dr. Porter).
Footnotes
Accepted for publication March 4, 1965.
Presented at the American Academy of Dermatology meeting, Chicago, Dec 1964.
Reprint requests to Department of Dermatology, Hitchcock Clinic, Hanover, NH (Dr. Jillson).
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