Prevalence and Sociodemographic Profile of Lithium-induced Cutaneous Side Effects in Bipolar Affective Disorder Patients: A 1-year Prospective Observational Study in South India

OBJECTIVES: Objective in our study is i) To assess the prevalence and sociodemographic profile of cutaneous side effects in bipolar affective disorder patients (BPAD) on lithium. ii) To assess the course of pre-existing skin reactions, when patient is initiated on lithium therapy. METHODS: Lithium induced cutaneous side effects were assessed at baseline and monthly for 6 months followed by every 2 months over a year. Dermatologist opinion obtained to diagnose and treat for each patient who developed cutaneous side effects. Data were analyzed in percentage. RESULTS: The prevalence of lithium induced cutaneous side effects in our study is 38.46%. On analyzing the individual subtype of cutaneous lesions, acneiform eruption and hairfall were most common. The cutaneous adverse reactions on lithium are more common in early adulthood than in the late adulthood and geriatric age group and among the subtypes of skin lesion acneiform eruptions are more common among males than in females. On analyzing the course of pre-existing lesions, severe alopecia developed with pre-existing systemic lupus erythematosis. CONCLUSION: These novel finding indicate that prevalence of lithium induced cutaneous side effects continues to be high. Hence, clinician should educate the patients before initiating lithium to improve attrition rate.