To analyse the level of medical accuracy in atopic illnesses is the purpose of this study. The heterogeneous aspect of atopic disease, its severity, response to medication, triggers, the genetic backbone, ancestrals and inflammatory conditions is being increasingly recognised as heterogeneous. This enormous heterogeneity in the landscape of atopic illnesses is not reflected in the standard guidelines for treatment following the ‘one fits all’ approach. Such an approach is mostly based on minimum “phenotype” characteristics, such as illness, gravity or therapeutic reactions, and in the last 20 years it does not provide information accumulating on certain pathways (endotypes) that contribute to disease (phenotypes). Accumulative data have identified allergy to asthma, food allergy based on their endotypes, and phenotypes of therapeutic relevance. In general, atopic conditions can be characterised mainly as high or low Th2 inflammatory conditions that can explain therapeutic severity and responsiveness.

Precision medicine seeks to use known phenotypes to drive particular tailored treatments. Taking account of the available treatment that is ever more accurate to target specific pathways, the effort aiming to deeply characterise diseases that guide the management of diseases is vital.