Atopic dermatitis (AD) is a common inflammatory skin disease that occurs most frequently in children. The disease is characterized as chronic, but only 20% of children suffer from severe AD, while the other 80% reach a long-term remission by the age of 8. The aim of the research was the analysis of modern sources of domestic and foreign literature, highlighting the features of the course of severe forms of AD. Results. The multifactorial nature of AD pathogenesis, based on the complex interaction of genetic factors, the immune system, the skin microbiome and environmental factors, causes certain difficulties for the physician, both in the diagnosis and therapy selection, and in predicting the course of the disease. Each patient has his own individual combination of clinical symptoms, medical history and aggravating factors that should be considered as predictors of the severity of the disease. Conclusion. Particular attention should be paid to patients with an early onset of AD, increased transepidermal water loss, with extensive skin lesions at the onset of the disease and under dynamic observation, with concomitant food allergies and/or bronchial asthma. Copyright© GEOTAR-Media Publishing Group.