Background and purpose: Atopic dermatitis (AD) is a chronic or relapsing inflammatory skin disease which affects 10–20% of children and 1-3% of adults. Recently microbial agents particularly fungi have received more attention as the aggravating factors of AD. Fungi could be found throughout the world. Some fungal genera are as the normal flora, and some of them are abundantly found in the environment. The purpose of this study was to review recent knowledge concerning the pathogenesis of AD regarding the role of fungi. Materials and methods: A comprehensive literature search of published studies from 1966 until 2011 about the role of fungi in AD was performed using PubMed/MEDLINE and Iranian databases. Results: Malassezia, Candida, Alternaria and Cladosporium were the most common fungi that most studies found their role in atopic dermatitis. Frequency of Candida and Malassezia-colonization was higher in AD patients. Moreover, the presence of type I hypersensitivity reaction to Malassezia, Candida, Alternaria and Cladosporium was seen considerably in patients with AD. Conclusion: Fungi are important sources of allergens which could trigger cutaneous inflammation in patients with AD. Therefore, we suggest clinicians to pay more attention on screening and treatment of fungal hyper colonization and type I hypersensitivity reaction to fungi in patients with AD, especially, those not responding to traditional treatments

Keywords: Atopic dermatitis, alternaria alternata, candida, cladosporium herbarum, malassezia

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