Vaginal ulcerations due to lithium carbonate therapy

Area of Science:

• Dermatology
• Pharmacology
• Gynecology

Background:

• Lithium carbonate is a mood stabilizer commonly prescribed for bipolar disorder.
• Long-term use of lithium carbonate can be associated with various side effects.
• Cutaneous and mucosal adverse reactions to lithium carbonate are infrequently reported.

Observation:

• A 29-year-old woman presented with ulcerated vaginal mucosal lesions and acneiform eruptions on her thighs.
• The patient had a 7-year history of lithium carbonate treatment.
• Histopathology of skin biopsies revealed lichenoid cutaneous changes.

Findings:

• The observed vaginal and thigh lesions were consistent with a lichenoid drug reaction.
• Discontinuation of lithium carbonate led to the complete resolution of the cutaneous lesions.
• This case suggests a potential link between long-term lithium carbonate use and lichenoid reactions affecting both skin and mucosa.

Implications:

• Clinicians should consider lithium carbonate as a potential cause of lichenoid dermatitis and mucosal ulceration.
• Discontinuation of the offending agent is crucial for managing drug-induced cutaneous and mucosal reactions.
• Further research may be warranted to elucidate the precise mechanisms of lithium-induced dermatologic and gynecologic adverse events.