Dermatological effects lithium

Weight gain is a frequent side effect of lithium treatment. Dermatological Effects... 

The more common dermatological effects of lithium treatment are rash and acne-like lesions. Whether to stop lithium therapy is determined by the severity of either of these conditions. 

The cutaneous adverse effects of lithium have been reviewed (401,402). Lithium can cause aggravation of psoriasis. Other dermatological problems related to lithium treatment include acne, folliculitis, and maculo-papular eruptions. The prevalence of dermatological difficulties is up to 45%, although many have reported a much lower rate, less than 4%. Men are more susceptible to than women. Most patients can be managed without withdrawing lithium, but aggravation of psoriasis may make it necessary. 

A 26-year-old woman with bipolar I disorder took lithium and valproate, and sometimes additional risperidone and lamotrigine. Both risperidone and lamo-trigine produced dermatological adverse effects. Her serum lithium concentration was 0.82 mmol/1. Topiramate 75 mg/day was added. A week later, she continued to show a mixed state with mostly manic features and a raised lithium concentration of 1.24 mmol/1. The lithium concentration continued to increase over the next 4 days to 1.97 mmol/1 even though the lithium dosage was reduced from 900 to 750 mg/day. Lithium was withdrawn and the lithium concentration fell. Lithium was then restarted at half the admission dose to achieve a blood concentration of 0.67 mmol/1. Subsequent increases in the dose of topiramate resulted in further increases in the lithium concentration. 

A number of other side effects of lithium have been noted after prolonged therapy, including exacerbation of dermatological disorders, mild leukocytosis, hypothyroidism, and hypoparathyroidism. 

---