ABSTRACT
Since lithium came into widespread use before the advent of current regulatory policies, we do not have generalizable rate estimates for its adverse skin reactions. The existing literature is methodologically limited. At best, we can say that the risk of adverse skin reactions lies between 7 and 34%1-3. Among patients remaining on lithium monotherapy for over 10 years, the incidence of adverse skin reactions has been reported to be less than 7%4, but this estimate may be explained in part by early cohort dropouts. Studies reporting estimates at the higher end of the range are limited by retrospective design2, recall bias2 and referral bias3. On the whole, acne and psoriasis are the most frequently encountered cutaneous reactions.
