Study IDs Signs of Topical Steroid Withdrawal in Atopic Dermatitis

WEDNESDAY, Jan. 22, 2025 (HealthDay News) — Self-reported manifestations of topical steroid withdrawal (TSW) in atopic dermatitis (AD) include erythema, desquamation, dryness, and oozing affecting the face, neck, and upper extremities, according to a study published online Jan. 3 in Acta Dermato-Venereologica.

Mikael Alsterholm, M.D., Ph.D., from the Karolinska Institutet in Stockholm, and colleagues conducted an observational cross-sectional study involving adults reporting both AD and TSW. A questionnaire was posted in a Swedish TSW-themed Facebook group and was accessed by 98 participants and completed by 82.

Most respondents were female (95 percent), self-diagnosed with TSW (84 percent), and reported current symptoms of AD and TSW. The researchers note that TSW was defined as dependence on topical glucocorticoids (TGCs) and adverse reactions to their use. The most reported signs were erythema, desquamation, dryness, and oozing affecting the face, neck, and upper extremities. The most reported symptoms were pruritus, sleep disturbance, and signs of anxiety and depression. Sixty percent of respondents reported recurring episodes of manifestations attributed to TSW. Ninety-three percent believed that TGCs were the personal trigger factor, while 33 percent also identified oral glucocorticoids. Twenty-one percent currently use TGCs.

“As of now, TSW remains an exclusion diagnosis after careful ruling out of established causes for adverse reactions to TGCs,” the authors write. “This stance requires that the patients” concerns and beliefs are respected by empathic and open-minded health care providers who uphold an evidence-based approach and offer alternatives to TGCs when possible.”

Several authors disclosed ties to the pharmaceutical industry.

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