Can the atopic march be predicted?

The "atopic march" refers to the progression from inflammatory skin manifestations in early life, usually diagnosed as "atopic dermatitis," to subsequent food allergy, asthma, and allergic rhinitis. Hill and Spergel1 note that the skin inflammation likely results from a primary skin barrier defect interacting with genetic or environmental susceptibility, which could lead to the development of inflammation mediated by T-helper cell type 2. However, up to two-thirds of children with atopic dermatitis do not have atopy as judged by skin prick test reactions or serum immunoglobulin E levels.

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