Carmen - October 27, 2024
Hi, this is Tina Fortune. I want to ask for help on behalf of my niece, Carmen Lewandowski.
For those who know Carmen, she is delightful, kind, artistic, and always friendly. Camen is also a cellist and a highland dancer, but above all, she is a humanitarian and loves to help others.
In early October 2024 (during Carmen's first term at the University of Victoria), Carmen developed a devasting Topical Steroid Withdrawal Flare (TSW). The severity of this flare forced her to drop out of university and come home.
What is Topical Steroid Withdrawal? Topical Steroid Withdrawal (TSW), also known as Red Skin Syndrome, is a dermatological condition associated with the cessation of topical corticosteroid (TCS) use after prolonged and sometimes inappropriate application. TSW is characterized by a severe rebound phenomenon, wherein the skin undergoes a period of intense inflammation and distressing symptoms following Topical Steroid Cream (TSC) discontinuation. This condition has garnered increased attention and recognition among patients and medical practitioners.
Studies have shed light on the clinical presentation of TSW. One notable study by Hajar Tadros et al. (2019) reported that patients experiencing TSW often exhibit erythema, burning, pruritus, and skin shedding, with severe psychological distress. These symptoms can significantly impact patients’ quality of life. Furthermore, studies, such as that conducted by Fukaya et al. (2014), have examined the histological changes associated with TSW, revealing features such as epidermal thinning and telangiectasia. The pathophysiology of TSW is not yet fully elucidated but is believed to involve the suppression of the hypothalamic-pituitary-adrenal axis, skin barrier dysfunction, and altered immune responses.
Throughout Carmen's youth, she experienced a lot of eczema. As the years progressed, she eventually gave in to using over-the-counter hydrocortisone cream, and despite only using 1.5 tubes over the course of two years, the products caused Carmen's epidermis to be so thin that she became easily susceptible to infections and inflammation. Today, her TSW is to the point where she can not go to school or work. She is in constant pain and itchy, and it is impossible to sleep.
Carmen has tried everything imaginable to heal her skin: every cream, supplement, and treatment (Red Light Therapy, Hyperbolic Chamber, Acupuncture, Naturopathic doctors, and her local MD). Every practitioner and friend has been very supportive and kind, and Carmen is very grateful for their help. Although these treatments have had some measure of success, they did not prevent this horrible flare and do not address skin atrophy resulting from using TSC.
Thank you, Tina
September 4, 2024 - Carmen and Stefan - of to the University of Victoria
Carmen - Playing cello at the Capital Theatre in Nelson
Carmen and I - she was the cutest little kid - and still is!!!
Link to the TSWAssist Website
Carmen's Instagram webpage - documenting her TSW journey
Organizer and beneficiary
Terri Fortune
Beneficiary