Comprehensive Physiology Wiley Online Library
For Librarians For Authors Editors About

Cutaneous Allergic Response

Rudolf L. Baer, David R. Bickers

10.1002/cphy.cp090120

Source: Supplement 26: Handbook of Physiology, Reactions to Environmental Agents

Originally published: 1977

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Obligatory Damaging Factors
2 Nonobligatory Damaging Factors
3 The Immune System
4 Sequence of Events in Allergic Sensitization
5 Requirements for Antigenicity
5.1 Incomplete Antigens
5.2 Carrier Molecules
6 Lymphocytes
6.1 B and T Cells
7 Macrophages
8 Immediate Hypersensitivity
8.1 Antibodies
8.2 Pharmacological Mediators
9 Delayed Hypersensitivity
9.1 Lymphocyte Transformation
9.2 Lymphokines
10 Delayed Versus Immediate Hypersensitivity
11 Route of Exposure
12 Role of Peripheral Sensitization and of Lymph Nodes
13 Amplification
14 Sensitizing and Tolerogenic Effects
15 Immunologic State of the Host
15.1 Genetic Factors
15.2 Conditions of Exposure
15.3 Immunologic Deficiencies
16 Environmental Allergenic Substances
16.1 Small Molecular Allergens in Nature
16.2 Man‐Made Small Molecular Allergens
16.3 Microorganisms
16.4 Allergens from Flora and Fauna
17 Clinical Expressions of Cutaneous Allergic Reactions
17.1 Eczematous Allergic Reactions
17.2 Indurated Inflammatory Reactions
17.3 Urticarial Reactions and Angioneurotic Edemas
18 Combined Effects of Environmental Allergens and Radiant Energy
19 Autoimmune Cutaneous Reactions
20 Conclusions
Figure 1. Figure 1.

Biopsy specimen from an allergic eczematous contact reaction, showing intraepidermal vesicle formation and a superficial perivascular infiltrate, consisting of lymphocytes and histiocytes, × 65.
Figure 2. Figure 2.

Biopsy specimen from a delayed skin‐test reaction (elicited with lymphogranuloma venereum skin‐test antigen) at 48 h, showing dense aggregates of inflammatory cells, including lymphocytes, histiocytes, and neutrophils around blood vessels at all levels of the dermis. There is edema in the papillary dermis. The epidermis is not significantly involved, × 70.
Figure 3. Figure 3.

Biopsy specimen from a zirconium‐induced skin lesion, showing epithelioid tubercles with histiocytes and giant cells in the upper part of the dermis. The epidermis is not significantly involved, × 65.
Figure 4. Figure 4.

Biopsy specimen from an allergic urticarial reaction, showing wide separation between collagen bundles at all levels of the dermis, caused by sudden edema. The epidermis is not involved, × 65.
Figure 5. Figure 5.

Proposed role of light in photoantigen formation (based on halogenated salicylanilide reactions).

From Harber et al. 22
Figure 6. Figure 6.

Antibodies against intercellular substances of epithelial structures in the serum of a patient with pemphigus vulgaris. Bright fluorescence, indicating presence of antibodies, is seen only in the intercellular areas of the section of guinea pig esophagus, a stratified squamous epithelium which is used as the substrate, × 65.


Figure 1.

Biopsy specimen from an allergic eczematous contact reaction, showing intraepidermal vesicle formation and a superficial perivascular infiltrate, consisting of lymphocytes and histiocytes, × 65.



Figure 2.

Biopsy specimen from a delayed skin‐test reaction (elicited with lymphogranuloma venereum skin‐test antigen) at 48 h, showing dense aggregates of inflammatory cells, including lymphocytes, histiocytes, and neutrophils around blood vessels at all levels of the dermis. There is edema in the papillary dermis. The epidermis is not significantly involved, × 70.



Figure 3.

Biopsy specimen from a zirconium‐induced skin lesion, showing epithelioid tubercles with histiocytes and giant cells in the upper part of the dermis. The epidermis is not significantly involved, × 65.



Figure 4.

Biopsy specimen from an allergic urticarial reaction, showing wide separation between collagen bundles at all levels of the dermis, caused by sudden edema. The epidermis is not involved, × 65.



Figure 5.

Proposed role of light in photoantigen formation (based on halogenated salicylanilide reactions).

From Harber et al. 22


Figure 6.

Antibodies against intercellular substances of epithelial structures in the serum of a patient with pemphigus vulgaris. Bright fluorescence, indicating presence of antibodies, is seen only in the intercellular areas of the section of guinea pig esophagus, a stratified squamous epithelium which is used as the substrate, × 65.

References
 1. Alexander, E. L., and B. Wetzel. Human lymphocytes: similarity of B and T cell surface morphology. Science 188: 732–734, 1975.
 2. Baer, R. L., D. L. Ramsay, and E. Biondi. The most common contact allergens 1968‐1970. Arch. Dermatol. 108: 74–78, 1973.
 3. Baer, R. L., S. A. Rosenthal, and B. Hagel. The effects of feeding simple chemical allergens to pregnant guinea pigs upon the sensitizability of their offspring. J. Immunol. 80: 429–434, 1958.
 4. Benacerraf, B., and P. G. H. Gell. Studies on hypersensitivity. I. Delayed and arthus‐type skin reactivity to protein conjugates in guinea pigs. J. Immunol. 2: 53–63, 1959.
 5. Burkhardt, W. Die Rolle des Alkali in der Pathogenese des Ekzems speziell des Gewerbeekzems. Arch. Dermatol. Syph. 173: 155–167, 1935.
 6. Chase, M. B. Inhibition of experimental drug allergy by prior feeding of the sensitizing agent. Proc. Soc. Exptl. Biol. Med. 61: 257–259, 1946.
 7. David, J. R. Lymphocyte mediators and cellular hypersensitivity. New Engl. J. Med. 288: 143–149, 1973.
 8. David, J. R., H. S. Lawrence, and L. Thomas. Delayed hypersensitivity in vitro. II. Effect of sensitive cells on normal cells in the presence of antigen. J. Immunol. 93: 274–278, 1964.
 9. Dvorak, H. G., A. M. Dvorak, B. A. Simpson, H. B. Richerson, S. Leskowitz, and M. J. Karnovsky. Cutaneous basophil hypersensitivity. II. A light and electron microscopic description. J. Exptl. Med. 132: 558–582, 1970.
 10. Dvorak, H. F., and M. C. Mihm, Jr. Basophilic leukocytes in allergic contact dermatitis. J. Exptl. Med. 135: 235–253, 1972.
 11. Dvorak, H. F., B. A. Simpson, R. C. Bast, Jr., and S. Leskowitz. Cutaneous basophil hypersensitivity. III. Participation of the basophil in hypersensitivity to antigen‐antibody complexes, delayed hypersensitivity and contact allergy. Passive transfer. J. Immunol. 107: 138–148, 1971.
 12. Edelman, G. M. Antibody structure and molecular immunology. Science 180: 830–840, 1973.
 13. Edelson, R. L., R. W. Smith, M. M. Frank, and I. Green. Identification of subpopulations of mononuclear cells in cutaneous infiltrates. I. Differentiation betwen B cells, T cells and histiocytes. J. Invest. Dermatol. 61: 82–89, 1973.
 14. Eisen, H. N., and S. Belman. Studies of hypersensitivity to low molecular weight substances. II. Reactions of some allergenic substituted dinitrobenzenes with cysteine or cystine of skin proteins. J. Exptl. Med. 98: 533–549, 1953.
 15. Eisen, H. N., L. Orris, and S. Belman. Elicitation of delayed allergic skin reactions with haptens. J. Exptl. Med. 95: 473, 1952.
 16. Eisen, H. N., and M. Tabachnik. Elicitation of allergic contact dermatitis in the guinea pig; the distribution of bound dinitrobenzene groups within the skin and quantitative determination of the extent of combination of 2.4 dinitrochlorobenzene with epidermal protein in vivo. J. Exptl. Med. 108: 773–796, 1958.
 17. Forsbeck, M., E. Skog, and K. H. Ytterborn. Allergic diseases among relatives of patients with allergic contact dermatitis. Acta Dermato‐Venereol. Suppl. 51: 123–128, 1971.
 18. Franklin, E. C. The immunoglobulins—their structure and function. Progr. Allergy 8: 57–110, 1964.
 19. Fregert, S., N. Hjorth, B. Magnusson, H.‐J. Bandmann, C. D. Calnan, E. Cronin, K. Malten, C. L. Meneghini, V. Pirila, and D. S. Wilkinson. Epidemiology of contact dermatitis. Trans. St. John's Hosp. Dermatol. Soc. 55: 17–35, 1969.
 20. Fregert, S., and N. Hjorth. The principal irritants and sensitizers. In: Textbook of Dermatology (2nd ed.), edited by A. Rook, D. S. Wilkinson, and F. J. G. Ebling. Oxford: Blackwell, 1972.
 21. Frey, J. R., and H. Geleick. Sensibilisierungsweg und Sensibilisierungserfolg beim Kontaktekzem des Meerschweinchens. Dermatologica 124: 389–397, 1962.
 22. Harber, L. C., H. Harris, and R. L. Baer. Photoallergic contact dermatitis due to halogenated salicylanilides and related compounds. Arch. Dermatol. 94: 255–262, 1966.
 23. Harber, L. C., R. M. Holloway, V. R. Wheatley, and R. L. Baer. Immunologic and biophysical studies in solar urticaria. J. Invest. Dermatol. 41: 439–443, 1963.
 24. Houser, D. D., C. E. Arbesman, K. Ito, and K. Wicher. Cold urticaria: immunologic studies. Am. J. Med. 49: 23–33, 1970.
 25. Ishizaka, K., T. Ishizaka, and M. M. Hornbrook. Physicochemical properties of human reaginic antibody. IV. Presence of a unique immunoglobulin as a carrier of reaginic activity. J. Immunol. 97: 75–85, 1966.
 26. Jerne, N. K. The Immune System. Sci. Am. 229: 52–60, 1973.
 27. Johansson, S. G. O., and H. Bennich. Studies on a new class of human immunoglobulins. II. Immunological properties. In: Gamma Globulins. Third Nobel Symposium, edited by J. Killander. Stockholm: Almqvist Wiksell, 1967.
 28. Keil, H., D. Wasserman, and C. R. Dawson. The relation of chemical structure in catechol compounds and derivatives to poison ivy hypersensitiveness in man as shown by the patch test. J. Exptl. Med. 80: 275–287, 1944.
 29. Landy, M., and W. Braun. Immunological Tolerance. New York: Academic, 1969.
 30. Lawrence, H. S. Transfer factor. Adv. Immunol. 11: 195–266, 1969.
 31. Levine, B. B., R. H. Stember, and M. Fotino. Ragweed hayfever: genetic control and linkage to HL‐A haplotypes. Science 178: 1201–1203, 1972.
 32. Lorincz, A. L. Hypersensitivity to trauma in Allergic Dermatoses due to Physical Agents, edited by R. L. Baer. New York: New York Univ. Press, 1956.
 33. Lowney, E. D. Attenuation of contact sensitization in man. J. Invest. Dermatol. 50: 244–249, 1968.
 34. Lowney, E. D. Immunologic unresponsiveness to a contact sensitizer in man. J. Invest. Dermatol. 51: 411–417, 1968.
 35. Macher, E., and M. W. Chase. Studies on the sensitization of animals with simple chemical compounds. XII. The influence of excision of allergenic depots on onset of delayed hypersensitivity and tolerance. J. Exptl. Med. 129: 103–121, 1969.
 36. Medawar, P. B. Transplantation of tissues and organs. Introduction. Brit. Med. Bull. 21: 97–99, 1965.
 37. Oort, J., and J. C. Turk. A histological autoradiographic study of lymph nodes during the development of contact sensitivity in the guinea pig. Brit. J. Exptl. Pathol. 46: 147–154, 1965.
 38. Pearson, M. N., and S. Raffel. Macrophage‐digested antigen as inducer of delayed hypersensitivity. J. Exptl. Med. 133: 494–505, 1971.
 39. Pomeranz, J. R. Studies on the evolution of immunologic unresponsiveness following hapten feeding. J. Invest. Dermatol. 56: 441–445, 1971.
 40. Silberberg, I., R. L. Baer, S. A. Rosenthal, G. J. Thorbecke, and V. Berezowski. Dermal and intravascular Langerhans cells at sites of passively induced allergic contact sensitivity. Cell. Immunol. 18: 435–453, 1975.
 41. Silberberg, I., G. J. Thorbecke, R. L. Baer, S. A. Rosenthal, and V. Berezowsky. Antigen‐Bearing Langerhans cells in skin, dermal lymphatics and in lymph nodes. Cell. Immunol. In press.
 42. Sulzberger, M. B. Hypersensitiveness to arsphenamine in guinea pigs. I. Experiments in prevention and desensitization. Arch. Dermatol. Syph. 20: 669–697, 1929.
 43. Sulzberger, M. B., and R. L. Baer. Studies in hypersensitivity to light. Preliminary Report. J. Invest. Dermatol. 6: 345–348, 1945.
 44. Tan, E. M., P. H. Schur, R. I. Carr, and H. G. Kunkel. DNA and antibodies to DNA in the serum of patients with systemic lupus erythematosus. J. Clin. Invest. 45: 1732–1740, 1966.
 45. Turk, J. C. Lymphocyte response to antigens. Afferent side of sensitization arc. Response of lymphocytes to antigens. Transplantation 5: 952–961, 1967.
 46. Walker, F. B., J. D. Smith and H. I. Maibach. Genetic factors in human allergic contact dermatitis. Intern. Arch. Allergy Appl. Immunol. 32: 453–462, 1967.
 47. Yoshimura, H. Organ systems in adaptation: the Skin. In: Handbook of Physiology. Adaptation to the Environment, edited by D. P. Dill. Bethesda, Md.: Am. Physiol. Soc., 1964, sect. 4, chapt. 8, p. 109–131.

Contact Editor

Submit a note to the editor about this article by filling in the form below.

* Required Field

Article Title: Cutaneous Allergic Response
 

How to Cite

Rudolf L. Baer, David R. Bickers. Cutaneous Allergic Response. Compr Physiol 2011, Supplement 26: Handbook of Physiology, Reactions to Environmental Agents: 323-336. First published in print 1977. doi: 10.1002/cphy.cp090120