Targeted Investigation of Microbiome Elimination

Open to people ages 18-80

1. Participant must be able to understand and provide informed consent
2. Meet Atopic Dermatitis Research Network (ADRN) Standard Diagnostic Criteria for active atopic dermatitis (AD)
3. At least 21 cm² of lesional and 21 cm² of non-lesional skin on both the right and left ventral arms. The required area (lesional or non-lesional) may be one contiguous area or may encompass multiple areas with a total cumulative area of 21 cm²
4. An Investigator Global Assessment (IGA) score, on the ventral arms of at least moderate severity
5. Body surface area (BSA), as measured by Mostellar BSA Calculator, between 1.26 m² and 2.25 m²
6. If female of child bearing potential, must agree to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraception (e.g. oral contraceptives, intrauterine device [IUD], barrier method with spermicide, or surgically sterilized partner, Depo- Provera, Norplant, NuvaRing, or hormonal implants) for the duration of study participation

1. Inability or unwillingness of a participant to give written informed consent or comply with study protocol
2. Pregnant or lactating females
3. Active bacterial, viral, or fungal skin infections
4. Any noticeable breaks or cracks in the skin on the target areas of investigational product application, including severely excoriated skin or skin with open or weeping wounds suggestive of an active infection or increased susceptibility to infection
5. Sensitivity to or difficulty tolerating Dove fragrance-free bar soap, Cetaphil® Lotion, alcohol-based cleaners, glycerol, or soy products
6. Participants with Netherton's syndrome or other genodermatoses that result in a defective epidermal barrier
7. Any participant who is immunocompromised (e.g. history of lymphoma, Human Immunodeficiency Virus [HIV]/Acquired Immunodeficiency Syndrome [AIDS], Wiskott-Aldrich Syndrome), has an immune system disorder (e.g. autoimmune disease), or is using a systemic immunosuppressant (e.g. systemic corticosteroids, cyclosporine, methotrexate)
8. Any participant with current malignant disease (with the exception of non-melanoma skin cancer in an area not affected by treatment)

9. Participants with a history of psychiatric disease or history of alcohol or drug abuse that would interfere with the ability to comply with the study protocol

   10. Past or current medical problems or findings from physical examination or laboratory

   testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.

   11. Ongoing participation in another investigational trial or use of investigational drugs

   within 8 weeks, or 5 half-lives (if known), whichever is longer, of the Screening Visit

   12. Treatment with non-steroid systemic immunosuppressant within 6 months of the Screening

   Visit

   13. Treatment with Dupilumab within 16 weeks of the Screening Visit 14. Treatment with oral or injectable therapy for AD (excluding oral steroids) within 5

   half-lives (if known) or 16 weeks before the Screening Visit, whichever is longer

   15. Participants with close contacts (e.g. spouse, children, or members in the same

   household) that have severe barrier defects or are immunocompromised

   16. Use of topical (including steroids and calcineurin inhibitors) AD treatments on the

   ventral arms or face within 7 days of the Treatment Visit; Use of topical steroids on areas outside of where investigational product is to be applied or swabbing is to be performed may be permitted, per investigator discretion

   17. Treatment with prescription moisturizers classified as medical device (e.g.,

   Atopiclair(R), MimyX(R), Epiceram(R), etc.) on the ventral arms or face within 7 days of the Treatment Visit; Use on areas outside of where investigational product is to be applied or swabbing is to be performed is permitted

   18. Use of any oral or topical antibiotic within 7 days of the Treatment Visit 19. Participants who have taken a bleach bath within 7 days of the Treatment Visit 20. Use of any oral steroid therapies within 28 days of the Treatment Visit 21. Any phototherapy for skin disease (such as narrow band ultraviolet B [NBUVB],

   ultraviolet B [UVB], ultraviolet A1 [UVA1], psoralen + UVA [PUVA]) or regular use (more than 2 visits per week) of a tanning bed within 28 days of the Treatment Visit