In a prospective study on atopic eczema (AE) several clinical major and minor features, including total IgE and response to Phadiatop testing, have been studied systematically and analyzed statistically with regard to diagnostic importance in patients with atopic enzema (AE) (n = 428) and in a sample of the normal population (NP) (n = 628). Total IgE was normally distributed in healthy controls, but bimodally distributed in AE. AE patients with concomitant inhalant atopy had significantly higher levels than pure AE patients. IgE and Phadiatop testing can be used to screen for inhalant atopy but not for atopic skin diathesis. Thus, the diagnosis of AE should be based on traditional anamnestic and clinical features. On the basis of chi-square values a diagnostic score system was constructed, which might help to establish a firm diagnosis of AE in patients with ambiguous cutaneous inflammatory disease. Based on this score system, patients with more than ten points should be considered as atopic, patients with more than six points are suspected of being atopic.