Sequential measurements were made of total and specific serum IgE concentrations in an adult patient with severe atopic eczema. Initially, the total serum IgE concentration and the concentration of IgE antibody to house dust mite were very high. These concentrations decreased over the next 3 years, following amelioration of her eczema. However, they rose again when her eczema worsened as a result of marital problems and fell once again with amelioration of her eczema after separation from her husband. The IgE concentrations to other common allergens, however, remained stable during this period. These results suggest that large amounts of house dust mite antigen may be scratched into the skin during clinical exacerbations of the eczema, this in turn aggravating the state of the skin because of hypersensitivity to the mite.