PROTEIN ALLERGENS: THE IMPORTANCE OF SKIN AS A ROUTE OF EXPOSURE

Protein contact with skin is associated with a number of clinical conditions, including protein contact dermatitis and immunologic contact urticaria. This article reviews the clinical, in vivo, and in vitro evidence that proteinaceous materials penetrate skin. It is concluded that while penetration of intact proteins through normal skin is extremely low and normally without consequence, any damage to the skin barrier may allow penetration. As a result, risk assessment for contact of protein with skin must take into account potential barrier impairment and thus the possibility of both the induction and the elicitation of allergic skin reactions.