A Review and Controlled Study of Cutaneous Conditions associated with Lithium Carbonate

Abstract

This study compares the incidence of a variety of cutaneous conditions among 91 patients treated with lithium carbonate with the incidence of such conditions among 44 patients treated with other non-neuroleptic, maintenance medications. Data on cutaneous conditions and allergies were obtained using structured interviews, demographic data, medication histories and personal and family histories. A significantly greater proportion of the lithium-treated patients than the comparison patients reported a cutaneous condition which may have been secondary to treatment in that it developed for the first time after the medication or appeared to have been exacerbated by the medication. Among the lithium-treated patients, females were found to be significantly more likely to report a secondary cutaneous condition. This effect was found across the whole range of cutaneous conditions. Male lithium-treated patients on the other hand reported approximately the same rate of secondary cutaneous conditions as both male and female comparison patients. Possible reasons for this sexual effect on incidence are discussed. The literature on cutaneous conditions which have been associated with lithium therapy is also reviewed.

Lithium, Antipsychotics, and Risk of Psoriasis

“…Furthermore, the only 2 patients in this study who developed psoriasis after exposure to lithium were older than 50 years. 12 These observations are supported by our data, which suggest an increased risk mainly in female patients older than 40 years (where a test for interaction by sex did not reach statistical significance). As the lithium mechanism on psoriasis is largely unknown, it is difficult to interpret these observations.…”

“…However, the hypothesis that lithium increases the risk of developing psoriasis has not been fully accepted. 10,12 Some reports have described patients with psoriasiform dermatitis rather than true psoriasis, and the mechanism of lithium action on psoriasis is still under discussion. 10,13 We therefore decided to study the association between lithium exposure and new-onset psoriasis in a large population-based case-control analysis, similar to a recent analysis on the use of A-blockers and psoriasis.…”

Drug-Induced Acneiform Eruption

“…[37][38][39] Lithium-induced acne is more frequent in men and among allergic patients. [40,41] The lesions are often inflammatory, occur abruptly, and involve the face but also the axilla, groin, arms, and buttocks. [37,42] There is no obvious dose-effect relationship and acne may appear even with normal serum lithium concentrations, although high concentrations of lithium may be observed in the skin, suggesting that the drug can accumulate in the skin, which might result in lesion occurrence.…”

Lithium and skin: dermatologic manifestations of lithium therapy

“…The reported prevalence in different published studies varies from 3.4 to 45%. In contrast with acute lithium toxicity, most of the cutaneous adverse effects occur at therapeutic serum levels 5–7 . The first controlled trial on the adverse cutaneous effects secondary to lithium treatment was conducted by Sarantidis and Waters 6 .…”