Exacerbation of Psoriasis during Lithium Treatment

@article{Sasaki1989ExacerbationOP,
  title={Exacerbation of Psoriasis during Lithium Treatment},
  author={T. Sasaki and Sumi Saito and Michiko Aihara and Junko Ohsawa and Zenro Ikezawa},
  journal={The Journal of Dermatology},
  year={1989},
  volume={16}
}
Exacerbation of psoriasis was observed in a 28‐year‐old patient following the addition of lithium carbonate to a treatment regimen of carbamazepine and other drugs for ***manic‐depressive psychosis. The biopsied lesion histologically showed a typical psoriasiform tissue reaction and immunohistochemically, remarkable infiltration of activated helper T cells. Immunologic reaction to lithium in a patch test and a lymphocyte proliferation test could not be demonstrated. The mechanisms of lithium… 

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References

SHOWING 1-10 OF 26 REFERENCES

Lithium compound treatment and psoriasis.

It is suggested that the psoriasis was induced or exacerbated by lithium compounds, and the skin changes disappeared or returned to pretreatment level after withdrawal of lithium compounds.

Exacerbation of psoriasis during lithium treatment

We report three patients with psoriasis and bipolar affective illness who showed marked deterioration of their skin condition when treated with lithium.

Linear IgA bullous dermatosis related to lithium carbonate.

A 26-year-old man presented with a six-month history of blisters involving his arms and hands, left lower leg and Sulfoxone sodium therapy was started with cessation of symptoms, but lithium therapy could not be reinstituted without new lesion formation.

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

Among the lithium-treated patients, females were found to be significantly more likely to report a secondary cutaneous condition, and this effect was found across the whole range of cutaneous conditions.

Psoriasis, polymorphonuclear leukocytes, and lithium carbonate. An important clue.

One of the characteristic histologic features of psoriasis is the accumulation of polymorphonuclear leukocytes in the stratum corneum, and it is demonstrated that psoriatic scale contains leukotactic substances that appear to be products of complement activation.

Mechanisms of lithium action.

The results have ranged from the production of severe and occasionally fatal Li to use as a psychoactive agent in the treatment of manic-depressive disorders.

Enhanced release of inflammatory mediators from lithium‐stimulated neutrophils in psoriasis

Evidence is presented for significant enhancement of degranulation of β‐ glucuronidase and vitamin Bi2‐binding protein from lithium‐stimulated neutrophils in psoriatic whole blood.

Perturbation of the human immune system by lithium.

Lithium increased lymphocyte responses to mitogens and lymphokine production was altered from migration stimulation factor to migration inhibition factor and it is proposed that lithium has an effect on the suppressor cell system.

Drug interaction?

There was a sudden and substantial improvement in her condition just as the skin was about to be closed (pulse 80/min, systolic pressure 110 mmHg and sinus rhythm on ECG), and the sudden return of an adequate cardiac output, apparently coincided with the characteristic and abrupt termination of action of this drug.

Inhibition of epidermal adenyl cyclase by lithium carbonate.

Investigation of the activity of adenyl cyclase in normal pig epidermis found decreased responsiveness to in vitro stimulation by epinephrine, histamine and adenosine when compared to skin from psoriatics who were not on lithium therapy, consistent with the observation that lithium therapy worsens psoriatic lesions.