Atopic eczema (AE) or atopic dermatitis (AD) is an inflammatory skin disease with involvement of genetic, immunological and environmental factors which are highly interconnected. 1,2 The heterogenic disease can be separated into different phenotypes and clinical presentations defined by the ethnicity, disease onset, disease severity, chronic vs acute, intrinsic vs extrinsic (IgE level), paediatric vs adult and inflammatory signature. [3][4][5] A common feature of all subtypes is a tremendous psychosocial burden for all patients with AE. 6 Prevalence varies by area and is reported to be 15-20% in children in Europe, persisting in up to 5-10% of adults. [7][8][9] Although severe cases are less abundant than mild or moderate disease pattern, 2% of affected children are severely suffering. 7,9 Therefore, AE remains to be a high and even increasing socio-economic burden in the United States and in Europe, 10,11 whereas slightly decreasing numbers were reported over the last few years in Japan. 12 Children often overcome atopic eczema, but set off on the so-called 'atopic march', that is begin a classic 'allergy career'. Scientifically, AE is a risk factor for the development of allergies. These are primarily type I allergies with clinical features such as hay fever and asthma. Allergies are increasingly becoming a widespread disease. Currently, almost every fourth person in Europe suffers from symptoms such as asthma or hay fever and the associated restrictions in everyday life or at work. For society, the reduced ability to perform at school, university and at work means great socio-economic damage.