Steroid Phobia / Topical Steroid Withdrawal — source conflicts

Conflict: [Li et al., JAMA Dermatology 2017] reports TCS phobia prevalence 21.0–83.7%; [Moret et al., PLoS One 2013] cites 40–73% and 80.7% admitting fear on a yes/no item; [Herzum et al., J Clin Med 2023] found 49% “severe” (TOPICOP >50%) in Italian parents. Prevalence is instrument- and cut-off-dependent. Unresolved — add to open_questions.

Conflict: Parent-community posts (Reddit, c. 2023–2025; anecdotal) say “Please stop using steroids; they are very harmful to the skin”. [NES/BDNG/BAD joint statement, Feb 2024] says TCS “can be used safely and effectively” and TSW “affects only a small proportion of patients seen by dermatologists”; [MHRA DSU, May 2024] calls TSW rare (267 reports vs >11 million prescriptions/yr) but frequency “cannot be confirmed”. Unresolved — add to open_questions.

Conflict: [MHRA DSU, Sept 2021, citing Juhasz 2017] says paediatric TSW can occur after as little as 2 months’ daily use; [Ahuja & Lio, Pediatric Dermatology 2025] found all paediatric cases with data had ≥3 months chronic use; [MHRA DSU, May 2024] says “generally 6 months or more”. Unresolved — add to open_questions.

Conflict: [2025 UK dermatologist survey, Skin Health and Disease] found 34% regard TSW as a distinct entity (48.5% unsure); [Barlow et al., cited therein] found 96% think most TSW complaints are relapsed eczema. Unresolved — add to open_questions.