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Background Serum thymus and activation-regulated chemokine (sTARC) levels reflect disease severity of atopic dermatitis (AD) in small study populations. It remains unclear whether sTARC is a reliable outcome measurement for AD severity in heterogeneous AD populations in daily practice. Objective We sought to assess the utility of sTARC as a biomarker for monitoring AD severity in adults in daily practice. Methods sTARC, clinical skin score (Six Area, Six Sign AD [SASSAD]), and body surface area measurements were collected from all adult patients with AD visiting our clinic between March 2009 and March 2012, at first visit or exacerbation (baseline). In addition, data from short-term and long-term follow-up visits were collected. Results At baseline sTARC levels ranged widely (n = 320; minimum-maximum: 3-50,400 pg/mL) and sTARC and SASSAD or body surface area correlated moderately. In the majority of patients, sTARC and SASSAD or body surface area changed congruently during follow-up. Limitations Data were collected retrospectively. Conclusion sTARC may represent a suitable biomarker for monitoring of AD severity in daily practice. [ABSTRACT FROM AUTHOR]