{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:25:27Z","timestamp":1785500727015,"version":"3.56.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Consensus amongst dermatologists regarding the phenomenon of topical steroid withdrawal (TSW) is elusive. This may be contrasted with a growing online patient movement, including social media communities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This study aimed to investigate dermatologist perspectives regarding TSW and to assess attitudes towards self-diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A two-part online questionnaire was disseminated to UK-based Dermatology Consultants, Registrars and Fellows. Section one presented a clinical scenario and randomized respondents into two groups: one mentioning TSW self-diagnosis, and an otherwise identical control without the self-diagnosis. Questions about the clinical scenario were directed to dermatologists and focused on attitudes regarding patient-predicted behaviours. Section two asked about TSW perceptions and experiences, and thematic analysis of open text responses was undertaken.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One hundred and three responses were received, including 51 Consultants, 38 Trainee Dermatologists, 10 Dermatology Fellows, 3 Specialty And Specialist (SAS) Dermatology doctors and 1 Post-CCT (Certificate of Completion of Training) Fellow. Thirty-four percent (n = 35\/103) of respondents considered TSW to be a distinct clinical entity, 17.5% (n = 18\/103) did not and 48.5% (n = 50\/103) were unsure. Respondents felt that self-diagnosing TSW patients were less likely to comply with treatment, and more likely to take up time and pose management problems compared with controls. Themes of uncertainty regarding diagnostic veracity and social media misinformation were identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Uncertainty regarding the veracity of a TSW diagnosis and its management is common amongst dermatology healthcare professionals (HCPs). Dermatology HCPs in this study considered that patients who self-diagnosed TSW were more difficult to engage with skin disease management. Dermatologists desire further understanding of and research into the nature and management of TSW.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/skinhd\/vzaf051","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:32:28Z","timestamp":1751358748000},"page":"281-288","source":"Crossref","is-referenced-by-count":6,"title":["Topical steroid withdrawal: self-diagnosis, unconscious bias and social media"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8162-1583","authenticated-orcid":false,"given":"Jonathan","family":"Guckian","sequence":"first","affiliation":[{"name":"University of Leeds Institute for Medical Education, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9587-9430","authenticated-orcid":false,"given":"Olivia","family":"Hughes","sequence":"additional","affiliation":[{"name":"School of Psychology, Cardiff University , Cardiff, Wales ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0796-7233","authenticated-orcid":false,"given":"Yasmin","family":"Nikookam","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Guys and St Thomas Hospitals , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ria","family":"Nair","sequence":"additional","affiliation":[{"name":"Newcastle University Medical School, Newcastle University , Newcastle upon Tyne ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aqua","family":"Asif","sequence":"additional","affiliation":[{"name":"Division of Surgery and Interventional Science, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Brown","sequence":"additional","affiliation":[{"name":"Health Research Institute, Medical School, Faculty of Health, Social Care & Medicine, Edge Hill University , Ormskirk, Lancashire ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Bewley","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Royal London Hospital, Bart\u2019s Health NHS Trust, & Queen Mary University London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheem","family":"Latheef","sequence":"additional","affiliation":[{"name":"Dermatology Department, Leeds Centre for Dermatology , Chapel Allerton, Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025073101314653000_vzaf051-B1","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":"2025073101314653000_vzaf051-B2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1093\/ced\/llac019","article-title":"#Corticophobia: a review on online misinformation related to topical steroids","volume":"48","author":"Finnegan","year":"2023","journal-title":"Clin Exp Dermatol"},{"key":"2025073101314653000_vzaf051-B3","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1080\/09546634.2021.1882659","article-title":"Topical corticosteroid withdrawal (\u2018steroid addiction\u2019): an update of a systematic review","volume":"33","author":"Hwang","year":"2022","journal-title":"J Dermatol Treat"},{"key":"2025073101314653000_vzaf051-B4","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/ced\/llad161","article-title":"Topical steroid withdrawal: an emerging clinical problem","volume":"48","author":"Brookes","year":"2023","journal-title":"Clin Exp Dermatol"},{"key":"2025073101314653000_vzaf051-B5","author":"Orr"},{"key":"2025073101314653000_vzaf051-B6","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":"2025073101314653000_vzaf051-B7","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s40261-021-01072-z","article-title":"Steroid phobia: is there a basis? 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