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Topical steroid rebound phenomena (TSRP) is a pericyte driven vascular normoxic pseudohypoxia, with backwards bifurcation and hysteresis.ABSTRACT: This paper presents the core mechanisms for the scope of impact explored in Decoding TSRP: The Pericyte Connection (doi.org/10.5281/zenodo.16907869) as the governing causal sequence. This synthesis consolidates those dynamics into a structured three-part equation mapping the interrelation between steroid potency, vascular enforcement, and terrain collapse:1. Blanching, pharmacodynamic endpoint = Efficacy2. Calcium-mediated pericyte constriction = Mechanism3. Pseudohypoxia from regulatory failure = Rebound

The model tracks rebound as terrain collapse triggered by pericyte-mediated vasoconstriction and its metabolic consequences. This frame provides a coherent mechanistic account of TSRP manifestation and formalizes the 1 + 2 = 3 equation as both explanatory and predictive. TSRP dynamics mirror pseudohypoxic signaling described in fibrotic and neoplastic contexts, where HIF activation proceeds despite normoxia via metabolic or oxidative stress disruption [Bae 2024; Brereton 2022; Hayashi 2018].