Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
On January 23, 2025, we reported on a study published in Acta Dermato-Venereologica that was designed to describe patient-reported characteristics of topical steroid withdrawal (TSW) in atopic dermatitis (AD).
The study
The observational cross-sectional study was initiated with an online questionnaire for participants aged 18 years and older posted to a Swedish TSW-themed Facebook group over a 4-week period in 2023. Participants had reported both AD and TSW; 98 users accessed the questionnaire and 82 completed it. The majority of respondents were women (95%), aged 18 to 39 years old (74%), and had self-diagnosed with TSW (84%).
The findings
The researchers reported variations in participant definitions of TSW, the most common being dependence on cortisone leading to symptoms upon decreasing or stopping treatment but many also defined the term as a reaction to cortisone during its use. Most (60%) reported current symptoms of AD and TSW.
More than half (60%) of the respondents reported recurring episodes of manifestations attributed to TSW. The personal trigger factor for symptoms attributed to TSW was believed by 93% of respondents to be topical glucocorticoids (TGCs) but 33% also identified oral glucocorticoids as the trigger. In their inquiries about reactions, the research team concluded that the most frequently noted physical signs included dryness, erythema, oozing, and desquamation, with symptoms mostly impacting participants’ neck, faces, and upper extremities.
Authors' comments
“The reactions following discontinuation were interpreted as a sign of withdrawal of glucocorticoids, distinct from a flare of the underlying AD. These symptoms were seen as dependency – not in the sense of needing treatment, but in the sense of induced addiction to a prescribed substance that resulted in a new set of symptoms, perhaps worse than the initial ailment."
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