Steroid Withdrawal Effects Following Long-term Topical Corticosteroid Use

Area of Science:

• Dermatology
• Clinical Medicine

Background:

• Topical steroid withdrawal (TSW) is a growing concern for patients using long-term topical corticosteroids (TCS).
• Currently, no established diagnostic criteria exist for TSW.
• This study investigates the characteristics of patients experiencing TSW.

Purpose of the Study:

• To examine the demographics and clinical outcomes of adult patients reporting TSW symptoms after chronic overuse of TCS.
• To propose potential diagnostic criteria for TSW based on patient history and examination findings.

Main Methods:

• Retrospective cohort study conducted in an Australian general practice.
• Data collected from patients presenting with TSW symptoms between January 2015 and February 2018.

Main Results:

• The study included 55 adult patients (56% female, mean age 32.9 years).
• 76% originally diagnosed with atopic dermatitis; 60% used potent TCS on the face; 42% had prior oral corticosteroid use.
• Common symptoms included burning pain (65%), widespread redness; specific signs like 'elephant wrinkles' (56%) were observed.

Conclusions:

• Long-term topical corticosteroid (TCS) overuse can lead to symptoms consistent with topical steroid withdrawal (TSW) upon cessation.
• Suggested diagnostic criteria are proposed to facilitate further research and clinical discussion on TSW.
• This research highlights the need for standardized diagnostic approaches to TSW.