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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2002 December;137(6):411-4

language: Italian

Cutaneous vasculitis ulcers during treatment with litium salts

Gatti M., Quaglini M., Bignamini E., Cespa M.

Clinica Dermatologica IRCCS Policlinico San Matteo, Pavia


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Lithium salts, in the form of carbonate and sulfate, are used in psychiatry in the therapy of maniacal psychosis and to prevent recurrent attacks in maniac-depressive psychosis. Litium salts are administered orally; they have a rapid absorption, the maximum seric concentration after 3 hours, and are renal excreted. Side-effects involve gastrointestinal, cardiovascular and central nervous system, kidney and skin (acne, folliculitis, psoriasis, dermatitis, vasculitis). A case of a 48-year-old woman under treatment with lithium carbonate for about 6 months is reported. The patient presented with erythematous-crusted lesions and malleolar edema. Skin biopsy for DIF and histological examination pointed out a leukocytoclastic vasculitis.
At the beginning the patient was treated with glucocorticosteroids i.m. and anti-inflammatory drugs; the treatment was unsatisfactory and, after psychiatric consultation, lithium salts have been replaced with carbamazepine. The patient was periodically examined and a complete resolution of the clinical picture was observed after 45 days. In this case ulcerate lesions can be considered as a secondary effect of the treatment with lithium salts: in fact, they were not present at the beginning of the therapy with this drug, but appeared after same months.

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