Immediate contact reactions

Abstract

Immediate contact reactions comprise a diverse spectrum of inflammatory skin reactions of both immune and nonimmune origin and involving several often poorly characterized mechanisms and which can be caused by an enormous variety of chemicals and proteins. Reactions range from sensory effects through local weal and flare to a more generalized response, but all generally characterized by a rapid onset after contact and relatively quick resolution over the space of 1-2 h. Where the reaction is immunological (mediated by IgE), it merges into the spectrum of responses caused by that antibody, including anaphylaxis. A wide range of chemicals have been implicated in the causation of nonimmune immediate contact reactions (including nicotinic acid esters, dimethylsulfoxide, benzoic and sorbic acid, cinnamic aldehyde, methyl salicylate, and various alcohols), whereas proteinaceous materials are more commonly associated with immediate immune-mediated reactions. Diagnosis is by clinical history, skin testing, and, where appropriate, serological analysis, but particularly for nonimmune responses may involve a considerable degree of clinical judgement. © 2011 Springer-Verlag Berlin Heidelberg.