Skin as a route of exposure to protein allergens

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 and other selected evidence that proteinaceous materials penetrate skin. It is concluded that whilst penetration of intact proteins through normal skin is extremely low and 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.