Topical Steroid Withdrawal in Atopic Dermatitis: Report from Sweden 特应性皮炎中的外用类固醇戒断：来自瑞典的报告

The predominant perceived symptoms of TSW (Topical Steroid Withdrawal) were pruritus, sleep disturbance, burning, stinging, and pain from the skin, with each being reported by more than 80% of participants. The most common signs observed were erythema, desquamation, dryness, and oozing of the skin. Although oedema was not included as a distinct response option, it was infrequently mentioned in free-text answers. The most commonly affected areas of the skin were the head and neck, as well as the forearms, including the hands.

The personal trigger factor for symptoms attributed to TSW was believed to be topical glucocorticoids (TGCs) by 93% (n = 76), while 33% (n = 27) also identified oral glucocorticoids (OGCs) as a trigger. Only 5% (n = 4) reported OGCs, but not TGCs, as their trigger. Additionally, 13% (n = 11) mentioned other triggers.

These findings from Sweden published in Jan 2025 highlight the predominant role of topical glucocorticoids (TGCs) as triggers in TSW, corroborating their direct association with the condition. The identification of oral glucocorticoids (OGCs) as an additional or sole trigger in some cases suggests the systemic impact of corticosteroids. Investigating the “other triggers” reported by 13% of participants could provide further insight into lesser-known factors contributing to TSW and aid in tailoring more comprehensive management strategies for affected individuals.

TSW（外用类固醇戒断）的主要症状是瘙痒、睡眠障碍、灼热感、刺痛和皮肤疼痛，每种症状均由超过80%的参与者报告。最常见的体征是红斑、脱屑、干燥和皮肤渗出（图1）。虽然水肿未被列为单独的选项，但在自由文本回答中偶尔被提及。最常受影响的皮肤区域是头部和颈部，以及包括手在内的前臂部位。

93%（n = 76）的患者认为TSW症状的个人诱因是外用糖皮质激素（TGCs），而33%（n = 27）的患者也将口服糖皮质激素（OGCs）视为诱因。只有5%（n = 4）的患者报告OGCs是诱因，但不包括TGCs。此外，13%（n = 11）的患者提到了其他诱因。

瑞典2025年一月发表的报告突出了外用糖皮质激素（TGCs）作为TSW主要诱因的作用，进一步证实了其与该病状的直接关联。部分患者将口服糖皮质激素（OGCs）视为附加或唯一诱因，表明糖皮质激素的全身性影响。对13%参与者提到的“其他诱因”进行深入研究，可能有助于揭示影响TSW的其他未知因素，并为受影响的个体制定更全面的管理策略。

Reference:

Topical Steroid Withdrawal in Atopic Dermatitis: Patient-reported Characterization from a Swedish Social Media Questionnaire. Acta Derm Venereol 2025; 105: adv40187. DOI: https://doi.org/10.2340/actadv.v105.40187