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Atopic dermatitis (AD) is a chronic inflammatory skin disease which develops on a complex genetic background, the so-called atopic diathesis. AD is in most, but not all, patients characterized by the presence of elevated total serum IgE levels. However, a subgroup of atopic patients exhibits normal IgE levels and mechanisms contributing to the so-called 'Intrinsic' or 'non-allergic' form have been the matter of intensive research work in the last years. These forms have been particularly studied in the context of AD, which has also led to a new nomenclature. Moreover, we now have increasing evidence for the putative role of autoimmune phenomena in the complex pathophysiology of AD. Mainly adult patients exhibit specific IgE directed against self proteins of epidermal origin. Therefore, AD may be considered as a continuous disease in which, however, depending on the age, different mutually not exclusive pathomechanisms may be of relevance.

1. Putative mechanisms underlying chronicity in atopic eczema