{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T02:04:42Z","timestamp":1773799482438,"version":"3.50.1"},"reference-count":21,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,7,15]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Topical steroid withdrawal (TSW) is a serious and often under-recognised dermatological condition. It is an adverse reaction to prolonged use of topical corticosteroids (TCS), which may occur following tapering or sudden cessation of treatment. TCS are widely used in the therapeutic management of various dermatological conditions, demonstrating notable efficacy in treating conditions such as atopic eczema and psoriasis. However, it is now recognised that prolonged use of TCS can lead to the development of TSW. TSW is characterised by the skin\u2019s dependence on exogenous steroids, with symptoms emerging when the skin becomes less responsive to treatment; when TCS are tapered or after they are discontinued. Common symptoms of TSW include burning, itching, erythema and skin thinning, which can extend beyond the original areas of steroid application.<\/jats:p>\n                  <jats:p>As public awareness of TSW continues to grow, the condition has also emerged as a pressing focus in dermatological research. Despite these advancements, the underlying pathophysiology of TSW remains intricate and only partially understood. Diagnosis poses a significant challenge due to the highly variable clinical presentations, emphasising the critical need for timely recognition. Early and accurate recognition not only prevent potential mismanagement but also ensure that patients receive the comprehensive support necessary to navigate this often-debilitating condition.<\/jats:p>\n                  <jats:p>This report presents and dissects a clinical case of TSW and includes a detailed account from a TSW patient over a period of 22 months. The report aims to highlight the complexities involved in diagnosing and managing the condition, emphasise the necessity for heightened awareness among clinicians and encourage the development of tailored interventions in clinical practice to address the unique challenges posed by TSW.<\/jats:p>","DOI":"10.1136\/bcr-2024-264476","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T01:00:13Z","timestamp":1765933213000},"page":"e264476","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Topical steroid withdrawal: a serious, under-recognised skin condition"],"prefix":"10.1136","volume":"18","author":[{"given":"Fatima N","family":"Hamed","sequence":"first","affiliation":[{"name":"Dermatology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9175-0626","authenticated-orcid":false,"given":"Rhiannon A","family":"Bates","sequence":"additional","affiliation":[{"name":"General Surgery, Doncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Daley","sequence":"additional","affiliation":[{"name":"Patient, Barnsley Hospital, Barnsley, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadi","family":"Abushaira","sequence":"additional","affiliation":[{"name":"Patient, Barnsley Hospital, Barnsley, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"2026022401300533000_18.12.e264476.1","unstructured":"Luger T , et al . Topical corticosteroids in dermatology. J Eur Acad Dermatol Venereol 2021."},{"key":"2026022401300533000_18.12.e264476.2","unstructured":"Menter A , et al . Guidelines of care for the management of psoriasis with topical therapies. J Am Acad Dermatol 2019."},{"key":"2026022401300533000_18.12.e264476.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2005.01.010"},{"key":"2026022401300533000_18.12.e264476.4","unstructured":"Hajar T , et al . Topical corticosteroid addiction and withdrawal in dermatology: a systematic review. Am J Clin Dermatol 2015;239\u201351."},{"key":"2026022401300533000_18.12.e264476.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-081X(02)00365-6"},{"key":"2026022401300533000_18.12.e264476.6","doi-asserted-by":"publisher","DOI":"10.1093\/ced\/llad161"},{"key":"2026022401300533000_18.12.e264476.7","unstructured":"Topical steroid withdrawal: a joint statement by national eczema society, the british dermatological nursing group, and the british association of dermatologists. 2024. Available: https:\/\/cdn.bad.org.uk\/uploads\/2024\/02\/22095550\/Topical-Steroid-Withdrawal-Joint-Statement.pdf"},{"key":"2026022401300533000_18.12.e264476.8","first-page":"431","article-title":"Steroid withdrawal syndrome","volume":"93","author":"Staughton","year":"1975","journal-title":"Br J Dermatol"},{"key":"2026022401300533000_18.12.e264476.9","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":"2026022401300533000_18.12.e264476.10","first-page":"1628","article-title":"The role of immune dysregulation in topical steroid withdrawal syndrome","volume":"140","author":"Choi","year":"2020","journal-title":"Investigative Dermatology"},{"key":"2026022401300533000_18.12.e264476.11","first-page":"3722","article-title":"Skin barrier function","volume":"124","author":"Elias","year":"2014","journal-title":"J Clin Invest"},{"key":"2026022401300533000_18.12.e264476.12","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2009.133"},{"key":"2026022401300533000_18.12.e264476.13","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":"2026022401300533000_18.12.e264476.14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03473.x"},{"key":"2026022401300533000_18.12.e264476.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1979.tb01905.x"},{"key":"2026022401300533000_18.12.e264476.16","doi-asserted-by":"publisher","DOI":"10.1111\/ced.15194"},{"key":"2026022401300533000_18.12.e264476.17","unstructured":"Medicines and Healthcare products Regulatory Agency. Literature review on TSW . Topical steroid withdrawal reactions: a review of the evidence - gov.uk. 2015."},{"key":"2026022401300533000_18.12.e264476.18","doi-asserted-by":"crossref","unstructured":"MedRxiv . Serum metabolomics suggest systemic lipid dysregulation. MedRxiv [Preprint] 2024. doi:10.1101\/2024.04.17.24305846","DOI":"10.1101\/2024.04.17.24305846"},{"key":"2026022401300533000_18.12.e264476.19","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2021.1882659"},{"key":"2026022401300533000_18.12.e264476.20","unstructured":"Ahuja K , Lio P . Topical Steroid Withdrawal Syndrome: A Retrospective Chart Review in a Specialty Center. J Integr Dermatol 2023;1."},{"key":"2026022401300533000_18.12.e264476.21","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"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264476","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:30:17Z","timestamp":1771925417000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":21,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,16]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2024-264476"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264476","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}