Pathomechanisms of Contact Sensitization

  • Philipp R. Esser
  • Stefan F. Martin
Allergic Skin Diseases (L Fonacier, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Allergic Skin Diseases


Contact sensitization is the initial process involved in the development of an allergic reaction to xenobiotic environmental substances. Here, we briefly describe the differences between irritant and allergic contact dermatitis. Then, we highlight the essential steps involved in the development of an ACD reaction, i.e., the protein binding of haptens, genetic factors influencing the penetration of sensitizers into the skin, the different mechanisms driving the initial development of an inflammatory cytokine micromilieu enabling the full maturation of dendritic cells, the role of pre- and pro-haptens, antigen presentation and T cell activation via MHC and CD1 molecules, dendritic cell (DC) migration, and potential LC contribution as well as the different T cell subsets involved in ACD. In addition, we discuss the latest publications regarding factors that might influence the sensitizing potential such as repeated sensitizer application, penetration enhancers, humidity of the skin, microbiota, Tregs, and phthalates. Last but not least, we briefly touch upon novel targets for drug development that might serve as treatment options for ACD.


Contact dermatitis Contact hypersensitivity Hapten Pathomechanism Potency Sensitization 



Allergic contact dermatitis


Adenosine triphosphate


Contact dermatitis


Contact hypersensitivity


Damage-associated molecular pattern






Di-iso-nonyl phthalate


Fluorescein isothiocyanate


Human beta defensin


High-mobility group box 1


Human serum albumin


Irritant contact dermatitis


Lymph node






Sodium dodecylsulfate


Para phenylenediamine


Quantitative structure-activity relationship


T cell receptor


Toll-like receptor


(Skin) resident memory T cell


(Lymph node) resident central memory T cell


Compliance with Ethics Guidelines

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Allergy Research Group, Department of DermatologyMedical Center-University of Freiburg, Faculty of Medicine, University of FreiburgFreiburg im BreisgauGermany

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