Isotretinoin Treatment of a Woman With Bipolar Disorder

Letter to the Editor

Sir: Lithium is widely believed to contribute to the onset or worsening of acne. This side effect causes concern for many patients who are already at risk for noncompliance due to the nature of their illness. Although the pathophysiology of the dermatologic reactions to lithium is speculative, there is convincing evidence that lithium increases migration of polymorphonuclear leukocytes into skin lesions.