Case Report: Erythema Multiforme Induced by Lithium Contact

Erythema multiforme (EM) is an acute, self-limited mucocutaneous disease with diverse triggers and frequent recurrences. A 24-year-old male who worked in a lithium battery factory developed multiple erythematous, itchy papules and plaques after a lithium-induced chemical burn. Histopathology of a right wrist lesion showed scattered lymphocytic infiltration, vacuolar degeneration, and necrotic keratinocytes, consistent with EM. He was treated with oral methylprednisolone and experienced recurrences after returning to the same workplace; lesions resolved with workplace avoidance. The pathogenesis of EM in this case is hypothesized to relate to lithium’s immunomodulatory effects, distinct from other etiologies. To our knowledge, this is the first report of EM following chemical burn and occupational lithium exposure.

SeokJin Cheol Kim, Young Kang, Bo Young Chung, Chun Wook Park, Hye One Kim