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Erythema Multiforme Induced by Lithium: A Case Report

Ya-Cheng Wang, Tzu-Chin Lin, Shu-Han Yu

A 28-year-old woman patient with bipolar I disorder was hospitalized due to manic symptoms, including talkativeness, decreased need for sleep, inattention, flight of ideas, and grandiosity.

After admission, the patient received que-tiapine 300 mg per night, lithium 300 mg twice a day and lorazepam 1 mg four times a day. On Day 3, her lithium dosage was increased to 900 mg per day due to insufficient serum level, 0.42 mEq/L.

On Day 9, she had fever of 38.6°C. The pa-tient had multiple discrete itchy and reddish pap-ules over the face, lips, palms, trunk and, limbs (Figure 1). She received an oral antihistamine (Oromin capsule, containing chlorpheniramine maleate 6 mg, riboflavin 2 mg, pyridoxine HCl 2 mg, and orotic acid 30 mg) four times per day, intravenous methylprednisolone 40 mg every 12 hours, and topical mometasone furoate 0.1% cream. Her lithium, quetiapine, and lorazepam were discontinued immediately.
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Editorial Committe, Taiwanese Journal of Psychiatry
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