Alsterholm Mikael, Af Klinteberg Maja, Vrang Sophie, Sigurdardottir Gunnthorunn, Sandström Falk MariHelen, Shayesteh Alexander
Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden.
Acta Derm Venereol. 2025 Jan 3;105:adv40187. doi: 10.2340/actadv.v105.40187.
Topical steroid withdrawal (TSW) is described as an adverse reaction to topical glucocorticoids (TGCs). A pathophysiological mechanism has not been identified. There are no diagnostic criteria. The aim was to describe patient-reported characteristics of TSW in atopic dermatitis (AD). An observational cross-sectional study was performed by posting a questionnaire for participants, aged ≥18 years, reporting both AD and TSW, in a Swedish TSW-themed Facebook group during 4 weeks in 2023. The questionnaire was accessed by 98 participants, with 82 completing it. Most were female (95%), 18-39 years old (74%), self-diagnosed with TSW (84%), and reported current symptoms of AD and TSW. They defined TSW as dependency on TGCs and adverse reactions to their use. Erythema, desquamation, dryness, and oozing affecting the face, neck, and upper extremities were the most reported signs. Pruritus, sleep disturbance, and signs of anxiety and depression were the most reported symptoms. Recurring episodes of manifestations attributed to TSW were reported by 60%. The personal trigger factor was believed to be TGCs by 93%, and 33% also identified oral glucocorticoids. TGCs were currently used by 21%. Self-reported manifestations of TSW are similar to those of AD but appeared to be distinguishable for the participants and caused considerable morbidity.
外用糖皮质激素撤药反应（TSW）被描述为对外用糖皮质激素（TGCs）的一种不良反应。其病理生理机制尚未明确。目前尚无诊断标准。本研究旨在描述特应性皮炎（AD）患者报告的TSW特征。2023年，在瑞典一个以TSW为主题的脸书群组中，对年龄≥18岁、同时患有AD和TSW的参与者发布了一份问卷，进行了一项观察性横断面研究。98名参与者访问了该问卷，其中82人完成了问卷。大多数为女性（95%），年龄在18 - 39岁之间（74%），自我诊断为TSW（84%），并报告了目前AD和TSW的症状。他们将TSW定义为对TGCs的依赖以及使用TGCs后的不良反应。面部、颈部和上肢出现的红斑、脱屑、干燥和渗出是报告最多的体征。瘙痒、睡眠障碍以及焦虑和抑郁症状是报告最多的症状。60%的人报告了归因于TSW的反复出现的表现。93%的人认为个人触发因素是TGCs，33%的人还提到了口服糖皮质激素。21%的人目前正在使用TGCs。自我报告的TSW表现与AD相似，但对参与者来说似乎是可区分的，并且会导致相当大的发病率。
