Breaking the cycle: a comprehensive exploration of topical steroid addiction and withdrawal.

IF 3.3 Q2 ALLERGY
Frontiers in allergy Pub Date : 2025-03-31 eCollection Date: 2025-01-01 DOI:10.3389/falgy.2025.1547923
Anish R Maskey, Akimi Sasaki, Manuel Sargen, Maureen Kennedy, Raj K Tiwari, Jan Geliebter, Bijan Safai, Xiu-Min Li
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Abstract

Topical steroid withdrawal (TSW) is a skin condition characterized by red burning, itchy, painful skin lesions, often accompanied by peeling, and cracking. Patients experience sleep disturbances due to intense itching, significantly impacting their quality of life. A majority of affected individuals develop secondary bacterial infection, marked by heavy colonization of Staphylococcus aureus (S. aureus) and alterations in the skin microbiome. TSW is described as a rebound effect following discontinuation of prolonged use of mid-to-high-potency topical corticosteroids. There exist no definitive diagnostic criteria for this entity, and it is often misdiagnosed as a flare-up of an underlying condition or a contact allergy. Despite numerous personal reports and experiences shared on online platforms, studies on TSW remain scarce in scientific literature. Recognizing and effectively managing this condition is critical for healthcare providers seeking to develop comprehensive management plans. These plans typically include supportive therapy for both physical and psychological symptoms, as well as the gradual tapering of corticosteroid use before complete discontinuation. This review aims to consolidate the existing knowledge on TSW, providing a comprehensive resource for its identification, management, and treatment. By enhancing understanding of TSW, this review seeks to support healthcare providers in implementing optimal management strategies and improving patient outcomes.

打破循环:局部类固醇成瘾和戒断的全面探索。
局部类固醇戒断(TSW)是一种皮肤状况,其特征是红色灼烧,瘙痒,疼痛的皮肤病变,通常伴有脱皮和开裂。由于强烈的瘙痒,患者会出现睡眠障碍,严重影响他们的生活质量。大多数受影响的个体发生继发性细菌感染,其特征是金黄色葡萄球菌(金黄色葡萄球菌)的大量定植和皮肤微生物群的改变。TSW被描述为停止长期使用中高效外用皮质类固醇后的反弹效应。对于这种实体没有明确的诊断标准,它经常被误诊为潜在疾病的突发或接触性过敏。尽管在网络平台上分享了大量的个人报告和经验,但在科学文献中,对TSW的研究仍然很少。认识和有效地管理这种情况是至关重要的医疗保健提供者寻求制定全面的管理计划。这些计划通常包括对身体和心理症状的支持治疗,以及在完全停药前逐渐减少皮质类固醇的使用。本文旨在巩固现有的TSW知识,为TSW的识别、管理和治疗提供全面的资源。通过加强对TSW的理解,本综述旨在支持医疗保健提供者实施最佳管理策略并改善患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.80
自引率
0.00%
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0
审稿时长
12 weeks
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