What is the range, extent and type of evidence about topic steroid withdrawal in research literature and social media platforms? A Protocol for an Evidence and Gap Map
Orr, N; Rogers, M; Stein, A; et al.Thompson Coon, J; Stein, K
Date: 8 June 2023
Other
Publisher
University of Exeter, College of Medicine and Health
Abstract
Topical corticosteroids (TCS) have been the mainstay of treatment for many skin disorders, including
chronic conditions such as atopic dermatitis (most common form of eczema), for more than 60
years. Research has shown that TCS are effective(1) but that their use is associated with a number of
adverse effects such as atrophy, striae, ...
Topical corticosteroids (TCS) have been the mainstay of treatment for many skin disorders, including
chronic conditions such as atopic dermatitis (most common form of eczema), for more than 60
years. Research has shown that TCS are effective(1) but that their use is associated with a number of
adverse effects such as atrophy, striae, rosacea, perioral dermatitis, acne and purpura.
(2) Topical
steroid addiction (TSA) is also an adverse effect, first recognised by Sneddon(3) in 1969 - although he
did not use the word ‘addiction’. According to Fukaya et al,
(4) the term ‘addiction’ was first used by
Burry(5) in Australia in 1973, who described how patients, like their skins, were ‘hooked’ on TCS and
“...afraid to stop using the topical steroids because of the rebound inflammation that would follow”
(p. 396). Writing in 1979, Kligman & Frosch(6) described addiction as an “insidious type of side
reaction,” often unrecognised, as “both physician and patient may fail to incriminate the steroid” (p.
24). However since then, there has been increasing recognition of TSA and interest in topical steroid
withdrawal (TSW), particularly amongst ‘patients’, as demonstrated by the growth in social media
addressing the side effects on those who discontinue long-term use of TCS.
Health and Community Sciences
Faculty of Health and Life Sciences
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