A control study of the cutaneous side effects of chronic lithium therapy.
BACKGROUND
To assess the nature and prevalence of skin disorders among psychiatric patients on chronic lithium therapy and to compare them with patients on other psychotropic medications.


METHODS
51 patients on lithium and 57 patients on other psychotropics were recruited. Dermatological assessment included a semi-structured questionnaire and clinical examination of the subjects by two dermatologists who were blind to the psychiatric diagnosis and treatment. Secondary cutaneous reaction was defined as skin eruption that developed or deteriorated after commencement of psychiatric medication.


RESULTS
Lithium treated patients developed significantly more secondary cutaneous reactions than the control group. This applied particularly to acne and psoriasis. Male patients on lithium were more likely to be affected than female patients.


CONCLUSIONS
Lithium aggravates or triggers cutaneous conditions that are characterized by the pathological findings of neutrophilic infiltration. Since these cutaneous problem can be distressing to patients and may affect medication compliance, there should be heightened attention to skin problems in patients receiving lithium treatment.
Chan
H H
HH
Division of Dermatology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong. henrychan@cuhk.edu.hk
Wing
Y
Y
Su
R
R
Van Krevel
C
C
Lee
S
S
D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008094:Lithium / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012871:Skin Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D018692:Antimanic Agents; D008094:Lithium