Table 2.

Reported signs and symptoms of TSA/TSW

Erythema

Widespread. May involve areas distant from original site of dermatitis or sites where TCS were never applied [12, 15, 17, 23, 66]

Oedema, exudation and oozing [12, 14, 23, 66, 68]

Burning or pain [12, 17, 23, 66]

Itching [12, 16, 23, 26, 66, 68]

Pustulation or Acneiform lesions [12, 30]

Vesiculation [12, 66]

Desquamation and skin shedding [23, 26, 66]

Lymphadenopathy [23, 66]

Red sleeve sign

Erythematous rash ending abruptly at the dorsal and palmar border, sparing the palms and soles [11, 15, 16, 23, 66]

Headlight sign

Eruption over the face, sparing of the nose and the upper lip [11, 16, 17, 66]

Elephant wrinkles

Thickened skin with reduction in skin elasticity, usually on the extensors [11, 16, 23]

These findings are reported from clinical observations, and objective differentiation from the primary dermatoses is challenging

TCS topical corticosteroid, TSA topical steroid addiction, TSW topical steroid withdrawal