Understanding Topical Steroid Withdrawal: Insights from Dr. Brad Glick

In a recent discussion at the 2025 Revolutionizing Atopic Dermatitis (RAD) Conference held in Nashville, Tennessee, Dr. Brad Glick, DO, MPH, a prominent dermatologist and director of the dermatology residency training program at Larkin Health System, offered valuable insights into the complexities of Topical Steroid Withdrawal (TSW) and its distinction from Atopic Dermatitis (AD). This conversation highlighted the critical need for healthcare professionals to recognize TSW, an inflammatory condition that can arise after prolonged use of topical corticosteroids, typically manifesting symptoms two to four weeks post-cessation of the steroid use.

Dr. Glick explained that TSW is characterized by a profound inflammatory response, often presenting as widespread redness and unique skin conditions such as the "red sleeve sign"—a sharp demarcation of redness at the wrist area. This condition, described by Dr. Glick, can be mistaken for severe flares of atopic dermatitis, complicating diagnosis and treatment.

According to Dr. Glick, detailed patient history is imperative to differentiate between TSW and AD, especially as many patients exhibit "steroid-phobia," a hesitance to properly utilize corticosteroids due to past mismanagement or misinformation. This phenomenon leads to inadequate treatment of their conditions, further exacerbating their symptoms.

"We need to be vigilant about recognizing TSW and ensuring patients are adequately informed about the correct usage of topical corticosteroids," Dr. Glick emphasized during the interview. He noted that recent advances in non-steroidal therapies, including biologics like dupilumab and JAK inhibitors such as abrocitinib, have shown promise in effectively managing TSW and AD.

The RAD Conference underscored the significance of understanding such conditions and the evolving therapeutic landscape. Dr. Glick noted that the recent surge in effective treatments for atopic dermatitis marks a pivotal change in dermatological care, providing hope for patients who previously faced limited options.

In addition to discussing TSW, Dr. Glick expressed enthusiasm for expanding therapeutic research into other dermatological conditions, particularly hidradenitis suppurativa, which remains underdiagnosed and inadequately treated despite the growing availability of new treatments.

The dialogue at RAD is part of a broader effort to refine therapeutic interventions for patients suffering from atopic dermatitis and related conditions. By focusing on accurate diagnosis and effective treatment strategies, healthcare providers can better support their patients' needs and improve overall outcomes in dermatological care.

For additional insights and updates on TSW and atopic dermatitis, visit the latest coverage from the RAD 2025 conference.