What should be the next step for a patient with severe atopic dermatitis and a SCORAD index of 53?

For a patient with severe atopic dermatitis indicated by a SCORAD index of 53, which reflects significant disease severity, the appropriate next step is to explain the need for systemic therapy due to the severity of the condition. Severe atopic dermatitis often does not respond adequately to topical treatments alone, especially when the disease is widespread and significantly impacts the patient's quality of life.

Systemic therapies, such as methotrexate, biologics (like dupilumab), or other immunosuppressive agents, are indicated to manage severe cases effectively. These treatments can help reduce inflammation, control symptoms more effectively, and improve overall skin health.

While initiating a referral to a dermatologist or discussing medication options might also be part of the treatment plan, the primary focus at this stage is to address the severity of the condition and the necessity for more aggressive treatment. It's essential for the patient to understand that their atopic dermatitis requires more than just topical management for effective control of their symptoms.