Immunoglobulin E: Pathogenic Relevance in Immediate Contact Reactions

  • Maria Estela Martinez-EscalaEmail author
  • Leah Ariella Kaplan
  • Ana M. Giménez-Arnau
Part of the Updates in Clinical Dermatology book series (UCD)


Contact urticaria syndrome, contact urticaria, and protein contact dermatitis are a heterogeneous group of immediate skin reactions clinically characterized by the presence of wheals, or eczema, or both, commonly limited to the exposed skin. Two pathogenic pathways have been described, which include a nonimmune-mediated mechanism and an immune-mediated mechanism. In the nonimmune-mediated mechanism, the agent directly causes skin reaction through vasogenic mediators, and therefore prior sensitization is not required to develop a skin reaction. Conversely, the immune-mediated mechanism consists of an IgE-mediated type I hypersensitivity reaction. This type of hypersensitivity requires an initial exposure to the antigen to induce a sensitization, causing the production of antigen-specific IgE that will induce mast cell degranulation after future exposures with the same antigen. Additionally, studies in vitro, as well as in vivo, have demonstrated supplementary roles of IgE beyond the immediate immune response subjected to the presence of a specific antigen. These antigen-independent roles of IgE have been shown to provide and prepare the perfect environment to induce the allergic response from the sensitization phase to amplification and perpetuation of this immune response. Herein, the roles of IgE in the immediate contact response, as well as those favoring its development, are reviewed.


Allergy CD23, contact immune reaction Contact urticaria FcεRI Immunoglobulin E Protein contact disease Pathogenesis Type I hypersensitivity Sensitization 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Maria Estela Martinez-Escala
    • 1
    Email author
  • Leah Ariella Kaplan
    • 2
  • Ana M. Giménez-Arnau
    • 3
  1. 1.Department of DermatologyNorthwestern University, Feinberg School of MedicineChicagoUSA
  2. 2.Tulane UniversityNew OrleansUSA
  3. 3.Department of DermatologyHospital del Mar - Institut Mar d’Investigacions Mediques, Universitat Autònoma de Barcelona (UAB)BarcelonaSpain

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