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Br J Dermatol2026;194(4):768-778.March 19, 2026Journal Article

Topical steroid withdrawal syndrome: developing diagnostic criteria through a modified Delphi method.

Cynhia Hsu1,2, Lily Guo1,3, Derrick Adams4, Dawn Davis5, Lawrence Eichenfield6, Olivia Hsu Friedman7, Sarah Harris8, Rocco Serrao9, Belinda Sheary10, Vivian Shi11, Robert Sidbury12,13, Eric Simpson14, JiaDe Yu15, Peter Lio16
1Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA.
2Advocate Christ Medical Center, Internal Medicine, Oak Lawn, IL, USA.
3Department of Dermatology, Brown University, Providence, RI, USA.
4Twelve Bridges Dermatology, Lincoln, CA, USA.
5Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, MN, USA.
6Departments of Dermatology and Pediatrics, University of California, San Diego and Rady Children's Hospital-San Diego, San Diego, CA, USA.
7Amethyst Holistic Skin Solutions, Naperville, IL, USA.
8Patient Advocate, Chicago, IL, USA.
9Dermatologists of Southwest Ohio, Mason, OH, USA.
10Royal Randwick Medical Centre, Randwick, NSW, Australia.
11Department of Dermatology, University of Washington, Seattle, WA, USA.
12Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
13Department of Dermatology, Seattle Children's Hospital, Seattle, WA, USA.
14Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
15Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
16Department of Dermatology, Northwestern University, Chicago, IL, USA.
PubMed DOI

Abstract

BACKGROUND: Topical steroid withdrawal syndrome (TSW) is an adverse event following discontinuation of topical corticosteroids (TCS) and is of growing interest among patients and dermatologists. The absence of well-defined diagnostic criteria and limited insights into the pathomechanisms make diagnosis and future research challenging. OBJECTIVES: To propose preliminary diagnostic criteria for TSW…

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