Role of immunoglobulin E sensitization in eczema, previously referred to as atopic dermatitis

This review aims to clarify existing knowledge on the relationship between eczema and immunoglobulin (Ig)E sensitization. Over the years this debate has been complicated by unclear definitions of what constitutes an atopic individual. The new, uniform allergy nomenclature introduced by the European Academy of Allergology and Clinical Immunology and the World Allergy Organization uses the term eczema to denote what was previously known as 'atopic dermatitis' or 'atopic eczema'. Despite detailed knowledge of localized IgE-allergen interactions at the level of the skin, the exact role of IgE and IgE antibody sensitization in the disease process remains widely debated. The association between IgE sensitization and eczema has been clearly demonstrated in population-based studies. There is, however, variation in the strength of the association between IgE sensitization and eczema in hospital versus community studies. While IgE sensitization is not a useful disease discriminator, once other factors have been taken into account, knowledge of atopic status appears to have prognostic value in children with eczema, since IgE sensitization is associated with an increased risk of developing allergic respiratory disease later in life. These children may also experience a more persistent and severe disease.