BACKGROUND: Exposure to airborne allergens exacerbates symptoms of atopic dermatitis in sensitive patients. OBJECTIVE: We attempted to evaluate the therapeutic effect of Dermatophagoides farinae antigen-autoantibody immune complex therapy in atopic dermatitis. METHODS: Four patients with atopic dermatitis were treated with antigen-autoantibody immune complex therapy using D. farinae antigen for 1 year. The therapeutic effect was evaluated by clinical severity (erythema, excoriations, scale, pruritus, lichenification) and D. farinae specific antibodies, skin test to D. farinae, total IgE, eosinophil count and soluble vascular cell adhesion molecule-1 (VCAM-1). RESULTS: One of four patients had significant improvement in clinical severity and decrease in serum eosinophil count, but three of four patients had no significant improvement in clinical severity, skin test to D. farinae, total IgE, specific antibodies and soluble VCAM-1 after allergenantibody complex therapy except specific IgE to D. farinae. CONCLUSION: The efficacy of allergen-antibody complex therapy may be limited in some atopic dermatitis patients.