OBJECTIVES: Atopic dermatitis (AD) is an increasingly common, chronic, relapsing, inflammatory skin disease characterized by impaired epidermal barrier function and cutaneous inflammation. The prevalence of AD has steadily increased during the past few decades. The aim of this study was to comparatively investigate cytokine gene expression in the skin and peripheral blood of atopic dermatitis patients and healthy individuals. METHODS: Samples of skin and peripheral blood from 48 severe AD patients (SCORAD = 78,5 [57;89], IGA=4,2 [3,9;4,7]) at the age of 17 to 45 years and 20 healthy donors aged from 19 to 32 years were analyzed for gene expression of cytokines using real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS: In the skin of patients with AD, a significant increase of the level of gene expression was observed for interleukin (IL)-2r (p<0,0023), IL-5 (p=0,002), IL-6 (p<0,0023), IL-8 (p=0,01), IL-12B (p<0,0023), IL-10 (p<0,0023), IL-23 (p=0,002), IL-29 (p<0,0023), and transforming growth factor beta (TGF-beta) (p<0,0023) as compared to healthy individuals. In contrast, no difference between AD patients and healthy donors was detected with respect to cytokine gene expression in the peripheral blood. CONCLUSIONS: Activity of IL-2r, IL-5, IL-8, IL-12B, IL-23, IL-29, and TGF-beta that are markers of chronic inflammation and Th1 immune response in severe AD was predominant in the skin but not in the blood of AD patients.