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September 25, 1972

Lithium Carbonate Dermatitis

Author Affiliations

Amarillo, Tex

JAMA. 1972;221(13):1517. doi:10.1001/jama.1972.03200260053026

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To the Editor.—  An adult woman weighing 56 kg was taking lithium carbonate for a manic-depressive illness on a schedule of 300 mg three times daily followed by 300 mg four times daily on alternate days. Her condition was carefully monitored and it was stable with lithium levels at 0.8 mEq/liter. She received no other medication. A papular, intensely pruritic dermatitis appeared on the elbows and resembled early dermatitis herpetiformis. Skin biopsy was refused and four days later 165 mg of sulfoxone sodium was administered twice daily for a total of six doses with complete relief of itching; however, there was a sudden, pronounced recurrence of disabling manic symptoms. The next day the serum lithium level was 0.2 mEq/liter. Within four days the patient was again in a stabilized status with the administration of six doses of lithium carbonate in addition to the previously unchanged regimen.I wonder if others