Allergy airway diseases are prevailing in the world’s population. These are multifactor disorders in which the most important components are the genetic predisposition of the patient (atopy), modulatary effects by environmental factors, infections and irritants. The airway allergy may occur as immediate, late or dual in onset. Allergic airway reactions are not always limited to the area they originated. Some studies indicate that the relation between sensitization to aero-allergens and allergic reaction in other parts (especially dermal lesions) of the body. However, the mechanisms of distant manifestations after a local allergic reaction have not been elucidated. This review describes hypothetical molecular mechanisms of the development of systemic lesions especially at dermis in the effector phases of airway allergy, including the roles of adhesion molecles, cytokines, chemokines and several biological active mediators. The difference between reaction of distant manifestation and IgE-dependent allergic anaphylax will be briefly mentioned.