Immunologische grundlagen des atopischen ekzems

Atopic eczema is considered as the cutaneous manifestation of atopy. Atopic dermatitis is most likely a T-cell mediated inflammatory skin disease resulting first in acute dermatitis, which then leads to eczema. The diagnosis of atopic eczema is based on a score system that includes four clinical major criteria and large series of conditional minor criteria, including elevated serum IgE levels. The definite diagnosis of atopic dermatitis requires three major and three minor criteria (Table 1). Despite the close association of atopic dermatitis with the other manifestations of atopy and the established role of T cells in the induction of atopic eczema, the immune mechanisms underlying atopic eczema are far from being resolved. It is currently believed that the high sensitivity to toxic stimuli and a hypersensitive immune system, reacting to normally harmless protein antigens, the allergens, initiate an inflammatory cascade that ultimately leads to the eczema.