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What Causes Brittle Finger Nails While On Lithium?

Posted on Wed, 28 Dec 2016

Question: I have observed weird cracking on moons of my finger nails. I saw a doctor. he said it is due to chemical reaction. but I only handle adhesives for hobby purpose. I am taking lithium since three years for bipolar. can this thing happen due to lithium poisoning? the doctor also said is it not fungal infection. he gave me some cream and ni medication. please see the attached images and suggest something. I am worried because the moon on right hand middle finger has changed its color to slightly yellowish .

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
please provide images

Detailed Answer:
Hello XXXXX,

Thanks for writing to us back. I can n understand your concern. I could not find any image in attachment. Please try again or take help of customer care.

There are evidences that lithium can cause nail changes.

Also let me know dose of lithium and any other medicines you are taking.

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (42 minutes later)

I am taking lithium 400 mg twice daily. and 1 anti depressant at night. please find the below images.

Answered by Dr. Chintan Solanki (4 minutes later)

Brief Answer:
it is likely psoriasis

Detailed Answer:
Hi,

Thanks for images.

This is likely lithium induced Psoriasis. Please consult dermatologist for evaluation and treatment.

Take care dear.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (2 hours later)

respected sir I met the dermatologist and he said it is not likely to be psoriasis. he has asked me to continue with same cream for 4 days. I am not feeling any pain or irritation. I have given my blood sample for lithium test. if the levels are normal can I rule out the possibility of nail psoriasis completely? what other symptoms should I look for? please guide.

Answered by Dr. Chintan Solanki (6 hours later)

Brief Answer:
only dermatologist can confirm the cause

Detailed Answer:
Hi,

Thanks for information.

As such in my clinical practice I have not got more than 2 cases of nail changes by lithium. After your query I tried to search about the same. I reached to conclusion that there are many cases of nail changes by lithium. These changes are not related with high lithium level.

If it is not psoriasis then diagnosis should be done by proper examination by a dermatologist in person. Your dermatologist has made diagnosis of chemical reaction. You should believe him and wait for response of treatment. If no improvement you can take opinion of other dermatologist and then diagnosis of lithium induced nail changes can be done after liaison with your treating psychiatrist.

Wait for few days and revert back to me with progress.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Prasad