The skin represents a unique immunologic organ poised to protect the h
ost from invading organisms and environmental antigens. The skin is al
so an important target for a variety of allergic and autoimmune respon
ses. Mast cells are key to the pathogenesis of urticaria, angioedema,
and mastocytosis. Atopic dermatitis is the consequence of an immunoreg
ulatory abnormality resulting in a skin-directed T helper type 2 respo
nse. Allergic contact dermatitis is an example of classic delayed type
hypersensitivity. Circulating autoantibodies against the epidermis ar
e a key mechanism by which bullous skin diseases occur.