Updating our clinical concept of atopic dermatitis (AD) evolves from the better understanding of all the immunologic aberrations expressed by the polygenic combinations and permutations associated with the atopic diathesis. Recognizing the immunopathologic features of AD readily underscores that AD without "atopy" is an oxymoron. Appreciating "pruritus" as the impetus to scratch, which isomorphically gives rise to the "eczema," shifts the goal of management from suppressing inflammation to avoiding the triggers of pruritus. Recognizing the full spectrum of dermatologic findings in AD endorses the preferred label as a dermatitis, rather than the inferred restrictive label, atopic eczema. As our knowledge of immunology evolves, our criteria for the diagnosis and management of the atopic diathesis are sure to change.