Exacerbation of Darier Disease by Lithium Carbonate

Introduction: Darier disease (DD) and Hailey-Hailey disease (HHD) are rare autosomal dominantly inherited genodermatoses with mutations in the respective genes, ATP2A2 and ATP2C1, that encode the respective calcium adenosine triphosphatases SERCA2 and PMRI/SPCA. Lithium is an effective therapy used in psychiatry as prophylaxis against recurrent mania and to treat acute schizoaffective, impulsive, and alcoholic disorders. Methods: We discuss a patient with DD who claimed that her skin condition had flared after she was administered lithium therapy for bipolar disorder. Discussion and Conclusions: DD may flare after lithium therapy, an association that has rarely been reported. Not uncommonly, DD has been observed to coexist with affective disorders, with reports of the bipolar disorder susceptibility locus cosegregating with a separate DD gene. A mechanism by which lithium worsens disease has recently been studied in rats. DD's coexistence with affective disorders and the mechanisms by which lithium may cause exacerbation of DD and HHD are reviewed.