Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with cutaneous hyper-reactivity to environmental triggers that are innocuous to normal, non-atopic individuals.1 Major contributors to this hyperactivity are the many changes in the cutaneous and systemic immune responses in individuals with AD.2 One example is the production of raised levels of total serum immunoglobulin IgE and specific IgE to common allergens.3 However, the link between AD and allergen-specific IgE remains hotly debated.4 A recent systematic review revealed that the association with raised IgE was much lower in children with mild to moderate AD than in children with severe disease.3It has been postulated that the non-allergic, intrinsic dermatitis could be a pure, transitional form of AD.5