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Cao Guoxiu, Tan Qi, Wang Hua. Department of Dermatology, Children's Hospital of Chongqing Medical University�� Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, Chongqing 400014, China Corresponding author: Wang Hua, Email: Huawang63@hotmail.com ��Abstract�� Atopic dermatitis ��AD�� is a chronic inflammatory skin disease with high morbidity in children. Its pathogenesis is complex, and immunological abnormality plays a central role in it. Some patients with refractory AD poorly respond to conventional therapies based on immunoregulation, counteraction of inflammation and restoration of skin barrier. In recent years, there have been more and more reports on the therapeutic effect of targeted biological agents on refractory AD. The therapeutic mechanisms of targeted biological agents include inhibition of T/B lymphocyte activation, as well as release of relevant cytokines and inflammatory mediators. Studies have shown that interleukin-4 and CD20 antagonists are considerably safe and effective for the treatment of refractory AD. However, the efficacy of antagonists of tumor necrosis factor-α and IgE is controversial.