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Lookup NU author(s): Dr Rajesh NairORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 The Author(s).Background Consensus amongst dermatologists regarding the phenomenon of topical steroid withdrawal (TSW) is elusive. This may be contrasted with a growing online patient movement, including social media communities. Objectives This study aimed to investigate dermatologist perspectives regarding TSW and to assess attitudes towards self-diagnosis. Methods A two-part online questionnaire was disseminated to UK-based Dermatology Consultants, Registrars and Fellows. Section one presented a clinical scenario and randomized respondents into two groups: one mentioning TSW self-diagnosis, and an otherwise identical control without the self-diagnosis. Questions about the clinical scenario were directed to dermatologists and focused on attitudes regarding patient-predicted behaviours. Section two asked about TSW perceptions and experiences, and thematic analysis of open text responses was undertaken. Results One hundred and three responses were received, including 51 Consultants, 38 Trainee Dermatologists, 10 Dermatology Fellows, 3 Specialty And Specialist (SAS) Dermatology doctors and 1 Post-CCT (Certificate of Completion of Training) Fellow. Thirty-four percent (n = 35/103) of respondents considered TSW to be a distinct clinical entity, 17.5% (n = 18/103) did not and 48.5% (n = 50/103) were unsure. Respondents felt that self-diagnosing TSW patients were less likely to comply with treatment, and more likely to take up time and pose management problems compared with controls. Themes of uncertainty regarding diagnostic veracity and social media misinformation were identified. Conclusions Uncertainty regarding the veracity of a TSW diagnosis and its management is common amongst dermatology healthcare professionals (HCPs). Dermatology HCPs in this study considered that patients who self-diagnosed TSW were more difficult to engage with skin disease management. Dermatologists desire further understanding of and research into the nature and management of TSW.
Author(s): Guckian J, Hughes O, Nikookam Y, Nair R, Asif A, Brown J, Bewley A, Latheef F
Publication type: Article
Publication status: Published
Journal: Skin Health and Disease
Year: 2025
Volume: 5
Issue: 4
Pages: 281-288
Print publication date: 01/08/2025
Online publication date: 01/07/2025
Acceptance date: 29/05/2025
Date deposited: 18/08/2025
ISSN (electronic): 2690-442X
Publisher: Oxford University Press
URL: https://doi.org/10.1093/skinhd/vzaf051
DOI: 10.1093/skinhd/vzaf051
Data Access Statement: The data that support the findings of this study are available from the corresponding author, J.G., upon reasonable request
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