Article type
Abstract
Background: Topical Steroid Withdrawal Syndrome (TSWS) is a distinct adverse effect of prolonged use of topical corticosteroids (TCSs). It is a medically contested condition, has a limited evidence base and lacks high quality research. However, amongst the ‘patient community’ awareness has been increasing, with rapid growth in social media posts on TSWS and the introduction of online communities such as ITSAN (International Topical Steroid Awareness Network).
Objectives: To identify the range, extent and type of evidence on TSWS in the research literature and on social media platforms.
Method: Four databases were searched in August 2022; three blogging sites were searched from 4th to 6th October 2022 as well as Google; Instagram and Reddit were searched for the 100 most recent posts in February 2023. Study titles, abstracts and full texts were screened by two reviewers and a third was consulted to resolve any differences. We used EPPI Reviewer for coding, data extraction and to generate our interactive EGM.
Results: Eighty-two academic publications and 223 social media posts were included. The EGM is displayed as a matrix, using a years-research topics framework (years – rows, research topics – columns). It shows that the research evidence has increased over the years and focuses mainly on the physical skin symptoms, treatments and to a lesser extent, risk factors and disease mechanisms. The social media evidence has greater focus on the physical symptoms, both skin and non-skin, and mental health symptoms. It also focuses on how TSWS impacts relationships, activities of everyday living, and beliefs and attitudes. In the research evidence, the treatments to manage TSWS tend to be pharmacological but the social media evidence shows that while people use pharmacological treatments, they also use a range of non-pharmacological treatments.
Conclusions: The EGM presents the developing body of research evidence on TSWS, enabling a timely insight into the topics of interest to the medical and dermatological community. There is considerable scope for high quality research and future priorities include longer-term studies to assess the safety of prolonged use of TCSs and qualitative research to understand the lived experience of TSWS.
Objectives: To identify the range, extent and type of evidence on TSWS in the research literature and on social media platforms.
Method: Four databases were searched in August 2022; three blogging sites were searched from 4th to 6th October 2022 as well as Google; Instagram and Reddit were searched for the 100 most recent posts in February 2023. Study titles, abstracts and full texts were screened by two reviewers and a third was consulted to resolve any differences. We used EPPI Reviewer for coding, data extraction and to generate our interactive EGM.
Results: Eighty-two academic publications and 223 social media posts were included. The EGM is displayed as a matrix, using a years-research topics framework (years – rows, research topics – columns). It shows that the research evidence has increased over the years and focuses mainly on the physical skin symptoms, treatments and to a lesser extent, risk factors and disease mechanisms. The social media evidence has greater focus on the physical symptoms, both skin and non-skin, and mental health symptoms. It also focuses on how TSWS impacts relationships, activities of everyday living, and beliefs and attitudes. In the research evidence, the treatments to manage TSWS tend to be pharmacological but the social media evidence shows that while people use pharmacological treatments, they also use a range of non-pharmacological treatments.
Conclusions: The EGM presents the developing body of research evidence on TSWS, enabling a timely insight into the topics of interest to the medical and dermatological community. There is considerable scope for high quality research and future priorities include longer-term studies to assess the safety of prolonged use of TCSs and qualitative research to understand the lived experience of TSWS.