{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:19:39Z","timestamp":1791944379311,"version":"4.3.4"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T00:00:00Z","timestamp":1682726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Topical steroid withdrawal (TSW) is a newly described disease characterized by erythema and burning following discontinuation of prolonged use of mid- to high-potency topical corticosteroids. No consensus diagnostic criterion exists. TSW is frequently interpreted as flaring of the underlying disorder or contact allergy to topical treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To better characterize TSW symptomatology, detail our experience with management and assess the proportion of patients who pursue nonconventional management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective review of case notes collected from our multidisciplinary service between January 2019 and June 2021 was carried out to identify patients presenting with TSW.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nineteen cases of TSW were identified, 15 in females and 4 in males. The majority were &amp;lt; 35\u2005years old. Eighteen had atopic dermatitis. The most frequently reported features were redness, skin pain (typically \u2018burning\u2019), skin sensitivity, excessive skin flaking, insomnia and severe itching. There was a high burden of anxiety and depression, with three patients expressing suicidal thoughts. Nonconventional treatments were pursued by approximately half the cohort, some of whom sought private consultation with international dermatologists. Improvements were noted in the context of open psychodermatology consultations with an earlier introduction of conventional management options.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Many patients report dismissal by dermatology healthcare professionals, often driving them to seek help from unregulated online sources, heightening the burden of mental, social and physical morbidity. Dermatology healthcare professionals need to be aware of TSW and offer support with shared decision-making when considering treatments.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llad161","type":"journal-article","created":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T15:36:33Z","timestamp":1682782593000},"page":"1007-1011","source":"Crossref","is-referenced-by-count":37,"title":["Topical steroid withdrawal: an emerging clinical problem"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2509-4528","authenticated-orcid":false,"given":"Tenzin Sung-rab","family":"Brookes","sequence":"first","affiliation":[{"name":"Chelsea & Westminster Hospital NHS Foundation Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Barlow","sequence":"additional","affiliation":[{"name":"Sandwell and West Birmingham NHS Trust , West Midlands , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padma","family":"Mohandas","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Bewley","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,29]]},"reference":[{"key":"2023101016562977500_llad161-B1","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1111\/ced.15194","article-title":"Topical steroid withdrawal through the lens of social media","volume":"47","author":"Bowe","year":"2022","journal-title":"Clin Exp Dermatol"},{"key":"2023101016562977500_llad161-B2","author":"UK Government"},{"key":"2023101016562977500_llad161-B3","author":"National Eczema Society and British Association of Dermatologists"},{"key":"2023101016562977500_llad161-B4","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/DER.0000000000000387","article-title":"Steroid withdrawal effects following long-term topical corticosteroid use","volume":"29","author":"Sheary","year":"2018","journal-title":"Dermatitis"},{"key":"2023101016562977500_llad161-B5","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s40261-021-01072-z","article-title":"Steroid phobia: is there a basis? A review of topical steroid safety, addiction and withdrawal","volume":"41","author":"Tan","year":"2021","journal-title":"Clin Drug Investig"},{"key":"2023101016562977500_llad161-B6","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1111\/bjd.21770","article-title":"Topical steroid withdrawal syndrome: time to bridge the gap","volume":"187","author":"Cotter","year":"2022","journal-title":"Br J Dermatol"},{"key":"2023101016562977500_llad161-B7","doi-asserted-by":"crossref","first-page":"551","DOI":"10.2340\/00015555-3144","article-title":"Topical steroid withdrawal: a case series of 10 children","volume":"99","author":"Sheary","year":"2019","journal-title":"Acta Derm Venereol"},{"key":"2023101016562977500_llad161-B8","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1586\/17469872.1.4.547","article-title":"The red skin syndromes: corticosteroid addiction and withdrawal","volume":"1","author":"Rapaport","year":"2006","journal-title":"Exp Rev Dermatol"},{"key":"2023101016562977500_llad161-B9","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/DER.0000000000000602","article-title":"Cessation of long-term topical steroids in adult atopic dermatitis: a prospective cohort study","volume":"31","author":"Sheary","year":"2020","journal-title":"Dermatitis"},{"key":"2023101016562977500_llad161-B10","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.jaad.2014.11.024","article-title":"A systematic review of topical corticosteroid withdrawal (\u201csteroid addiction\u201d) in patients with atopic dermatitis and other dermatoses","volume":"72","author":"Hajar","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"2023101016562977500_llad161-B11","first-page":"4147","article-title":"Severe topical corticosteroid withdrawal syndrome from over-the-counter steroids","volume":"9","author":"Nguyen","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"2023101016562977500_llad161-B12","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jdcr.2018.06.012","article-title":"Dupilumab in the management of topical corticosteroid withdrawal in atopic dermatitis: a retrospective case series","volume":"4","author":"Arnold","year":"2018","journal-title":"JAAD Case Rep"},{"key":"2023101016562977500_llad161-B13","doi-asserted-by":"crossref","first-page":"131","DOI":"10.2147\/DHPS.S69201","article-title":"Topical steroid addiction in atopic dermatitis","volume":"6","author":"Fukaya","year":"2014","journal-title":"Drug Healthc Patient Saf"},{"key":"2023101016562977500_llad161-B14","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/JDN.0000000000000331","article-title":"Systematic review of the topical steroid addiction and topical steroid withdrawal phenomenon in children diagnosed with atopic dermatitis and treated with topical corticosteroids","volume":"9","author":"Juh\u00e1sz","year":"2017","journal-title":"J Dermatol Nurses Assoc"}],"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llad161\/50848321\/llad161.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/48\/9\/1007\/51992125\/llad161.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/48\/9\/1007\/51992125\/llad161.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T16:58:50Z","timestamp":1696957130000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/article\/48\/9\/1007\/7147043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,29]]},"references-count":14,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,4,29]]},"published-print":{"date-parts":[[2023,8,25]]}},"URL":"https:\/\/doi.org\/10.1093\/ced\/llad161","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9]]},"published":{"date-parts":[[2023,4,29]]}}}