The mechanism of lithium and beta-blocking agents in inducing and exacerbating psoriasis.
Documentation of psoriatic eruptions occurring with the initiation of various pharmacotherapy agents has been reported in the literature. Two such agents include lithium and beta-blocking drugs. By understanding the mechanism by which these drugs induce and exacerbate psoriasis, we may gain further understanding of the disease process of psoriasis as well as how to treat this side effect. This paper reviews the literature that has examined the mechanism by which lithium and beta-blockers may induce and exacerbate psoriasis. Mechanisms involving both immunologic and non-immunologic factors have been examined in various studies. No consensus has been reached and further investigation is needed. However, findings such as improvement with inositol supplementation in cases of lithium-induced and -exacerbated psoriasis and disparate histologic presentation of beta-blocker-induced psoriasis provide suggestions that both the origin and treatment of drug-induced psoriasis may be different than psoriasis that is unrelated to medications.
O'Brien
Meghan
M
University of Massachusetts Medical School, Worcester, MA, USA. meghan.obrien@umassmed.edu
Koo
John
J
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D001707:Biopsy, Needle; D002462:Cell Membrane / Q000187:drug effects / Q000502:physiology; D004721:Endoplasmic Reticulum / Q000187:drug effects; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007295:Inositol Phosphates / Q000378:metabolism; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D011379:Prognosis; D011565:Psoriasis / Q000139:chemically induced* / Q000473:pathology* / Q000503:physiopathology; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D015398:Signal Transduction / Q000187:drug effects*; D012867:Skin / Q000187:drug effects / Q000378:metabolism
D000319:Adrenergic beta-Antagonists; D007295:Inositol Phosphates; D016651:Lithium Carbonate