Acneiform Eruptions Caused by Lithium Treatment May Be Related to Demodex Mites (Prostigmata: Demodecidae): A Hypothesis

Acneiform eruptions are a common adverse effect of lithium treatment that may impact adherence. It is not clear why lithium may worsen these lesions and treatment has focused on traditional treatments for acne. <i>Demodex</i> mites are known to commensurably exist in a large fraction of humans and are known to cause dermatologic conditions in a minority of individuals. An association with acneiform eruptions is well documented but is generally believed to not be causative. We present a hypothesis that lithium treatment may alter the environment of <i>Demodex</i> mites in a fashion that may increase their propensity to cause disease. If that is accurate, treatment with acaricidal agents may be an additional option.