Lithium acne

摘要

A 40-year-old woman presented with a severe eruption of cysts, papules, nodules and a few comedones on her face (Figure 1). She had no other lesions on her body. She had no history of acne or other dermatologic conditions. She had started taking lithium carbonate 4 months earlier for the treatment of bipolar disorder; the outbreak began during this period. The results of a complete blood count and metabolic panel were normal, as were her levels of sex hormones and serum lithium. A skin biopsy showed follicular obstruction and cystic dilatation of the piloseba-ceous duct (Figure 1). We diagnosed lithium-related acne and recommended that lithium be replaced by an alternative drug. At her 6-month follow-up visit, the acneiform eruption had improved, and by 9 months it had completely resolved.