A. Lithium can aggravate psoriasis. The induction of psoriasis without pre-existing disease is
less common than exacerbation of existing disease. Not all patients with pre-existing psoriasis
have a flare when starting lithium and psoriasis is not considered to be a contraindication to
taking lithium for mania or depression. Similarly, other drugs such as antimalarials and indometacin can aggravate psoriasis. Psoriasis that has fl ared with lithium appears to be
more resistant to standard treatment modalities. Some preliminary evidence suggests that
supplemental inositol or omega-3-fatty acids may improve symptoms in patients with psoriasis
during lithium treatment. Histological studies on the skin lesions induced or aggravated by lithium
are equivocal; some support the lesions to be consistent with psoriasis, although others have
claimed the features as non-specifi c and refer to as psoriasiform dermatitis.