Atopic dermatitis: is it an allergic disease?

For many years controversy has surrounded the relation between allergy and atopic dermatitis. We critically review the evidence for the contribution of allergy, or IgE-mediated hypersensitivity reactions, to the pathogenesis of this disease. We conclude that, at present, there is scant evidence that allergy is central to the development of atopic dermatitis, although it may be an aggravating factor in a few patients. Hence there is little rationale for the routine use of allergy testing or dietary and environmental manipulation in the management of this disease.