Augmentation of skin response by exposure to a combination of allergens and irritants - a review.

Clinical experimental studies on contact dermatitis (CD) often evaluate the effect of one allergen or one irritant at a time. In real life, the skin is often exposed to more allergens, more irritants or allergens and irritants in combination. This combined exposure may potentially influence irritant effects as well as allergenicity of the substances. Mechanisms for a changed response can be immunological effects or enhanced penetration. Knowledge about the influence on skin reaction of combined exposures may influence skin reactivity and is important for prevention of CD. For allergens, threshold values may be influenced by the presence of other allergens or irritants, and prevention of CD by regulation of threshold values may not be sufficient if this is not taken into account.