Background: Atopic dermatitis (AD) is a chronic inflammatory and complex skin disease, typically occurring in individuals with a personal or family history of atopy. It is characterized by lesions of dermatitis, pruritus and dry skin (xerosis) that evolve with chronic course and intermittent outbreaks alternating with remission phases. AD appears from 5-15 % of the general population, 10-20 % of the pediatric population, and 1-3 % of the adult population. Case report: A 19-year-old male patient with a severe AD (SCORAD of 84.3), and hyper-IgE (34 400 UI/mL), who was treated with deflazacort, Healing creams and emollients, as well as detergent-free gel. With which did not progress favorably, so a combinated therapy with deflazacort, methotrexate, tacrolimus, and transfer factor was prescribed, obtaining excellent results. Conclusion: There are many algorithms reported in the literature for the treatment of AD, but the evolution of the disease is the only one that will give us the guidelines for the treatment to be followed.