Atopic dermatitis (AD) skin lesions exhibit epidermal and dermal thickening, eosinophil infiltration, and increased levels of the cysteinyl leukotriene (cys-LT) leukotriene C 4 (LTC 4 ). Epicutaneous sensitization with ovalbumin of WT mice but not ΔdblGATA mice, the latter of which lack eosinophils, caused skin thickening, collagen deposition, and increased mRNA expression of the cys-LT generating enzyme LTC 4 synthase (LTC 4 S). Skin thickening and collagen deposition were significantly reduced in ovalbumin-sensitized skin of LTC 4 S-deficient and type 2 cys-LT receptor (CysLT 2 R)-deficient mice but not type 1 cys-LT receptor (CysLT 1 R)-deficient mice. Adoptive transfer of bone marrow-derived eosinophils from WT but not LTC 4 S-deficient mice restored skin thickening and collagen deposition in epicutaneous-sensitized skin of ΔdblGATA recipients. LTC 4 stimulation caused increased collagen synthesis by human skin fibroblasts, which was blocked by CysLT 2 R antagonism but not CysLT 1 R antagonism. Furthermore, LTC 4 stimulated skin fibroblasts to secrete factors that elicit keratinocyte proliferation. These findings establish a role for eosinophil-derived cys-LTs and the CysLT 2 R in the hyperkeratosis and fibrosis of allergic skin inflammation. Strategies that block eosinophil infiltration, cys-LT production, or the CysLT 2 R might be useful in the treatment of AD.murine model of atopic dermatitis | eicosanoid S kin thickening with hyperkeratosis and increased type I collagen deposition is an important feature of chronic atopic dermatitis (AD) (1). Eosinophil infiltration of target tissues is an important feature of allergic diseases, including AD. Tissue eosinophilia has long been associated with fibrosis because eosinophils and their derived products are commonly present in inflammatory fibrotic lesions (2). In addition to the release of cytotoxic granule proteins, which include major basic protein and eosinophil cationic protein, eosinophils secrete an array of inflammatory and fibrogenic mediators, including lipid mediators, chemokines, and cytokines (3). Accumulating evidence has suggested a potential role for eosinophils in airway remodeling in asthma. Genetic ablation of eosinophils, or reduction of pulmonary eosinophilia by targeting IL-5, significantly reduces subepithelial deposition of ECM proteins in a mouse model of chronic pulmonary inflammation (4). In mild asthmatics treated with anti-IL-5, reduction of infiltrating numbers of eosinophils in the bronchial mucosa was associated with a significant decrease in the expression of ECM proteins (5).Cysteinyl leukotrienes (cys-LTs) include leukotriene C 4 (LTC 4 ), which is synthesized by a variety of cells and enzymatically converted into leukotriene D 4 and then leukotriene E 4 by cleavage of its peptide side chain. LTC 4 is formed by LTC 4 synthase (LTC 4 S) through the conjugation of glutathione to the unstable intermediate leukotriene A 4 (LTA 4 ) which is generated by the action of 5-lipoxygenase (5-LO) on released arachidonic acid in the presenc...