22 An Introduction to Medical Mycology 



may occur if the extract is contaminated with bacteria. They noted that 

 many superficial tinea infections gave positive reactions. Although other 

 authors noted a reaction to trichophytin in patients who also had pityriasis 

 rosea, they were unable to confirm this observation. They concluded that 

 "intradermal tests with trichophytin are an aid in diagnosing mycoses of 

 the glabrous skin." Later Williams reported that "the trichophytin test ap- 

 pears to be specific and on careful examination of the patient and of his 

 history exceptions are usually found to be only apparent." Sulzberger and 

 Wise stated that an overwhelmingly large majority of patients who have 

 trichophytids react to the intradermal injection of trichophytin with an 

 inflammation not to be observed in normal persons who have had no 

 prior contact with fungi. They warned against relying on the test as a 

 positive means of identifying an eruption on the hands, since the reaction 

 may be positive because of a prior infection or an infection in another 

 part of the body. The specificity of trichophytin when compared with 

 oidiomycin was demonstrated by Sulzberger, who injected serum from 

 a patient who was known to have circulating antibodies into the skin of 

 normal young women who were previously without sensitiveness. The sites 

 were then tested, and reactions were obtained to trichophytin but not 

 to oidiomycin. 



Pels and Schlenger used trichophytin in testing 230 subjects. They 

 found the reaction to be positive in 83 per cent of 65 patients who showed 

 the clinical characteristics of the disease. Of 165 subjects who were clin- 

 ically free of the disease, 35 per cent had positive reactions. In some of 

 the cases fungi were demonstrated. Pels and Schlenger were not entirely 

 convinced that trichophytin is specific in its effect. 



Muskatblit and Director made their own trichophytin and tested 350 

 patients. Of 49 patients with fungous infections proved by culture, 41 had 

 positive reactions and eight no reaction. The results of the tests were as 

 follows: Epidermophyton interdigitale, 22 positive, one negative; Epider- 

 mophyton rubrum, six positive, three negative; E. inguinale, three positive, 

 none negative; M. lanosum, seven positive, one negative; Trichophyton 

 violaceum, two positive, none negative; T. gypseum, one positive, none 

 negative; A. schoenleini, one positive, one negative; Microsporum minu- 

 tissimum, none positive, one negative. These authors warned against 

 "depot" reactions in which the response was not greater than the original 

 injection of material. 



Goodman and Marks used the nitrogen content of trichophytin and 

 various bacterial products as the basis for their standardization. They 

 found that when like amounts of the antigens, on the basis of this stand- 

 ardization, were administered intraeutaneously, some patients reacted indis- 



