From the Royal Randwick Medical Centre, New South Wales, Australia.
Dermatitis. 2018 Jul/Aug;29(4):213-218. doi: 10.1097/DER.0000000000000387.
Concerns about topical steroid withdrawal (TSW) are leading some patients to cease long-term topical corticosteroid (TCS) therapy. Diagnostic criteria for this condition do not exist.
The aim of this study was to examine the demographics and outcomes in adult patients who believe they are experiencing TSW following discontinuation of chronic TCS overuse.
This was a retrospective cohort study of patients in an Australian general practice presenting with this clinical scenario between January 2015 and February 2018.
Women represented 56% of the 55 patients seen, and ages ranged from 20 to 66 years (mean, 32.9 years; median, 30.0 years). Seventy-six percent had an original diagnosis of atopic dermatitis. Sixty percent had used potent TCSs on the face, and 42% had a history of oral corticosteroid use for skin symptoms. Burning pain was reported in 65%; all had widespread areas of red skin; and so-called "elephant wrinkles," "red sleeve," and the headlight sign were seen in 56%, 40%, and 29%, respectively.
Patients with a history of long-term TCS overuse may experience symptoms and signs described in TSW on stopping TCSs. Diagnostic criteria, reflecting the histories and examination findings of the patients studied, are suggested in this article with the aim to advance discussion and research into TSW.
由于担心局部皮质类固醇戒断（TSW），一些患者停止长期使用局部皮质类固醇（TCS）治疗。目前尚无该疾病的诊断标准。
本研究旨在检查在停止长期 TCS 过度使用后，认为自己患有 TSW 的成年患者的人口统计学特征和结局。
这是一项回顾性队列研究，研究对象为 2015 年 1 月至 2018 年 2 月期间在澳大利亚一家普通诊所出现这种临床情况的患者。
55 名患者中女性占 56%，年龄在 20 至 66 岁之间（平均 32.9 岁；中位数 30.0 岁）。76%的患者最初诊断为特应性皮炎。60%的患者在面部使用强效 TCS，42%的患者有因皮肤症状口服皮质类固醇的病史。65%的患者报告有烧灼感；所有患者均有广泛的红斑；56%、40%和 29%的患者分别出现所谓的“象皮纹”、“红袖子”和“车头灯征”。
长期 TCS 过度使用者在停止 TCS 后可能会出现 TSW 描述的症状和体征。本文提出了反映研究患者病史和检查结果的诊断标准，旨在推进 TSW 的讨论和研究。
