CUTANEOUS EFFECTS OF LITHIUM - REVIEW OF THE LITERATURE AND A CASE-REPORT

This case report highlights the cutaneous effects of lithium. Dermatol ogical side-effects have been reported since lithium has been used in the 70s. It mainly exacerbates psoriasis, sometimes leading to serious pustular or generalized forms or resistance to usual therapeutics. Ps oriasis may also appear in subjects free from this disease, usually mo re frequently in people with a family history of psoriasis. Lithium ca n increase acne or induce acneiform eruptions, the treatment of which must avoid tetracycline antibiotics. Other erythematous pruritic rashe s may occur as well as rare cases of severe skin disease, like exfolia tive dermatitis or lupus-like syndromes. Dystrophic disorders of the n ails and especially hair may occur. Xerosis can be mild but disturbing in every day life as in this case, in which compliance has been shatt ered for this reason. Cutaneous side-effects of lithium seem to be dos e-dependent and can lead first to reduce serum lithium levels. If skin condition does not improve, lithium discontinuation might be the only possibility left, reintroduction usually leading to a relapse of the dermatologic disorder. At last, topical lithium has antiviral and posi tive cutaneous effects, now of interest in the dermatological field.