Acneiform eruption, psoriasis, folliculitis, and maculopapular eruption have been described as adverse reactions to lithium therapy. The hand tremor associated with lithium therapy is usually a fine rapid intentional tremor. A wide variety of other nervous system effects have been reported and include ataxia, dysarthria, hyperreflexia, other movement disorders, EEG changes, blackouts, stupor, coma, central incontinence, sleep disturbances, dizziness, vertigo, pseudotumor cerebri, seizures, and worsening of organic brain syndrome. Folliculitis, maculopapular rash, acneform eruptions, exacerbations of psoriasis, and lower extremity ulcers have also been reported. Acneiform eruptions are dermatoses that resemble acne vulgaris. Acnelike eruptions develop as a result of infections, hormonal or metabolic abnormalities, genetic disorders, and drug reactions. Those entities included in this discussion are nevus comedonicus, eruptive hair cysts, tuberous sclerosis, 1, 2 amineptine acne, steroid acne, chloracne, acneiform drug eruptions, gram-negative folliculitis, eosinophilic pustular folliculitis, Pityrosporum folliculitis, coccidioidomycosis, secondary syphilis, 3, 4 sporotrichosis, 5 rosacea, and perioral dermatitis. Papular and nodular lesions of the scalp, face, and neck.
French LE (ed): Adverse Cutaneous Drug Eruptions. For practical reasons and in the aim of helping clinicians, the different drug reactions described in this chapter are classified according to the main histological reaction pattern present. 1. a, b Maculopapular drug eruption. 6, 7 and EBV infections have been implicated in the pathogenesis. Acneiform and maculopapular eruptions, psoriasis, and folliculitis can occur with lithium. Dosage should then be adjusted to achieve a serum lithium level of 0.8 to a maximum of 1. When the acute symptoms have been controlled, recommendations for prophylaxis should be followed. Vascular disorders: Peripheral circulatory collapse, hypotension, Raynaud’s phenomena Gastrointestinal disorders: Nausea, vomiting, diarrhoea, gastritis, excessive salivation, dry mouth Skin and subcutaneous tissue disorders: Alopecia, folliculitis, pruritus, psoriasis exacerbation, rash and other signs of skin hypersensitivity, acneiform eruptions, papular skin disorder.
The underlying assumption of such a chapter is that the clinician has been able to identify the specific disorder in the patient and needs only to read about it in the textbook. (Table 72-1) When an eruption is characterized by elevated lesions, either papules (1 cm), in association with scale, it is referred to as papulosquamous. Comorbidities in patients with psoriasis include cardiovascular disease and metabolic syndrome.
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