PS03 Dermatologist perspectives on topical steroid withdrawal: distrust, disinformation and distance?

Abstract Topical steroid withdrawal (TSW) has become a polarizing phenomenon. The TSW been described as ‘intense erythema and burning…more prolonged than can be explained by the rebound vasodilation that occurs after discontinuing topical steroids’ (Cotter C, Burton T, Proctor A et al. syndrome: time to bridge gap. Br J Dermatol 2022; 187:780–1). However, acceptance consensus around diagnosis have proven elusive among dermatologists. This contrasts with growing patient movement online, > 572 million views of #topicalsteroidwithdrawal on TikTok. Disparities between clinician care implications, relating psychological wellbeing engagement services (Scott S, Deary I, Pelosi AJ. General practitioners’ attitudes patients self myalgic encephalomyelitis. BMJ 1995; 310:508). Self-reported previous emergent, ‘unexplained’ conditions like encephalomyelitis led negative regarding concordance, potentially leading worse outcomes burden. study aimed clarify dermatologist perspectives assess toward self-diagnosis. two-part online questionnaire was developed disseminated UK-based dermatology consultants, registrars fellows via social media email. Section one presented clinical scenario randomized respondents into two groups, mentioning self-diagnosis an otherwise identical control without Questions focused predicted behaviours. asked entity management experiences. Comparative data were analysed SPSS (IBM, Armonk, NY, USA) using statistical tests. In total, 103 responses received, including those from 51 consultants 38 registrars. Thirty-four per cent considered distinct entity, 17.5% did not 48.5% unsure. cohort had seen at least 599 presenting but made itself 157 times. Eighty-two linked 96.1% most associated eczema. Eighteen felt their receiving adequate care. There statistically significant differences whereby self-diagnosing less likely comply treatment (P = 0.003), more take up one’s 0.001), would pose difficult problems ≤ 0.001) desirable clinic lists compared controls 0.001). Qualitative themes included inappropriate use, mistrust desire for further research. Many dermatologists encounter self-diagnoses, uncertainty its validity is common. Clinicians see this phenomenon strongly eczema being driven media. Patients viewed negatively in terms concordance difficulty management. minority believe are Further research essential achieve support patients.