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May 2026 in “Frontiers in Immunology” Extracellular vesicles (EVs) play a dual role in atopic dermatitis (AD) by contributing to both its pathogenesis and potential treatment. Pathogen-derived EVs, such as those from Staphylococcus aureus, disrupt the skin barrier and promote inflammation, while therapeutic EVs from sources like mesenchymal stem cells show promise in restoring barrier function and modulating the immune response. Despite their potential, challenges such as standardization, mechanistic understanding, and safety data remain. Future research should focus on overcoming these challenges to harness EVs for precision diagnostics and therapies in AD.