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When tuberculin skin testing of adults is to be repeated periodically , the initial use of a two-step testing procedure can reduce the likelihood of interpreting a boosted reaction as representing recent infection . When tuberculin skin testing of adults is to be repeated periodically , the use of two-step testing initially can reduce the likelihood that a boosted reaction will be interpreted as representing recent infection . The seriousness of that sentence , underscored by the forceful action of the knife below , straddles this work between the realms of art and philosophy . On electron microscopy , reduced numbers of active melanocytes and a decrease in number and size of melanosomes is observed in affected skin . business and financial results is included in RealNetworks ? Lack of collegiality and difficulty in gaining credibility among peers exemplifies a characteristic of a negative environment identified by POWRE awardees . " They continued , " [ T ] he fact that some school districts and administrators are receiving a ' jolt ' after reviewing the initial results is a positive step in the right direction .