In summary, tuberculin skin testing might be fraught with problems.

To reduce some of the problems, a standard tuberculin is necessary.  This must be administered with a standard technique and be read in a standard way.

Due to differences in the prevalence of infection with environmental mycobacteria that cause cross-reactions, the specificity of the tuberculin skin test is not predictable.  It must be ascertained locally.

Cut-off points to denote presence or absence of tuberculous infection work in some settings, but not at all in others.

Mixture analysis to estimate the prevalence of tuberculous infection is promising and deserves further development.

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