The riddle of response to cutaneous allergen exposure in patients with atopic dermatitis

center dot Application of nonpathogenic antigen/allergen to normal skin typically induces tolerance. center dot Application of nonpathogenic antigen/allergen to inflamed/irritated skin; for example, eczema, may induce IgE-mediated hypersensitivity. center dot Keratinocytes, which make up the bulk of the epidermis, are part of the innate immune system and capable of releasing alarmins in the presence of pathogens and foreign antigens. center dot In patients with atopic dermatitis and peanut allergy, application of allergen to normal-appearing skin via epicutaneous immunotherapy can induce some degree of desensitization in most of patients.