Figure 2.

This demonstrates air-exposed atopic dermatitis in a 43-year-old man with a history of severe allergic rhinitis, asthma, and long-standing atopic dermatitis. At his initial presentation he reported intense nighttime itching and had failed multiple topical and systemic therapies for atopic dermatitis. His exam showed involvement primarily of the distal two-thirds of the arms, neck, and face. A diagnosis of airborne, protein-driven atopic dermatitis was made. Dust mite avoidance was initiated, along with barrier repair therapy with a ceramide-dominant moisturizer. Six weeks later, the patient reported that his skin was in the best condition he could recall in several decades.