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3 1. Albright, F., Burnett, C. H., Smith, P. H. and Parson, W.: Pseudohypoparathyroidism an example of "Seabnght-Bantam syndrome", Endocrino- logy, 30: , Elrick, H., Albright, F., Bartter, F. C., Forbes, A. P. and Reeves, J. D.: Further studies on Pseudohypoparathyroidism-report of four new cases, Acta Endocrinol., 5: , Mann, J. B., Alterman, S. and Hills, A. G.: Albright's hereditary osteodystrophy comprising pseudohypoparathyroidism and pseudopseudohypoparathyroidism., Ann. Intern. Med., 56: , 1962.

4 8. Bronsky, D., Kushner, D. S., Dubin, A. and Snapper, I.: Idiopathic hypoparathyroidism and pseudohypoparathyroidism case reports and review of the literature, Medicine, 37: , Eyre, W. G. and Reed, W. B.:Albright's hereditary osteodystrophy with cutaneous bone formation, Arch. Dermatol., 104: , bolism (Bondy, P. K., Rosenberg, L.E. Eds.), 6th Ed., WB Saunders Co, Philadelphia, 1969, Balachandar, V., Pahuja, J., Maddaiah, V. T. and Collipp, P. J.: Pseudohypoparathyroidism with 11. Miller, L. M. and Krane, S. M.: Cutaneous lesions normal serum calcium level, Am. J. Dis. Child., in nutritional, metabolic and heritable disorders, Dermatology in General Medicine (Fitzpatrick, T. B., Eisen, A. Z., Wolff, K., Freedberg, I. M. and Austen, K. F. Eds.) 2nd Ed., McGraw- Hill Book Co., N. Y., 1979, cutis and Albright's hereditary osteodystrophy, Br. J. Derm., 85: , Potts, J. T, Jr. and Deftos, L. J.: Parathyroid hormone thyrocalcitonin, vitamin D, bone and mineral metabolism, Duncan's Disease of Meta- 15. Barranco, V. P.: Cutaneous ossification in pseudohypoparathyroidism, Arch. Dermatol., 104: , Brook, C. G. D. and Valman, H. B.: Osteoma -

5 A Case of Pseudohypoparathyroidism with Cutaneous Ossification Sayoko Ohno, Tadashi Yokoo, Miyuki Ohta, Masamitsu Yamamoto, Yoshikazu Morita and Kiichiro Danno Department of Dermatology, Tenri Hospital Hitoshi Ishii Department of Endocrinology, Tenri Hospital Key words: pseudohypoparathyroidism-albright's hereditary osteodystrophy- Pseudopseudohypoparathyroidism-cutaneous ossification A 21-year-old woman with hard subcutaneous nodules on her left forearm visited Tenri Hospital for the tetanic convulsion. Examination revealed hypocalcemia, hyperphosphatemia and no phosphate excretion response to PTH. She was diagnosed as pseudohypoparathyroidism (PH). The histology of a subcutaneous nodule showed cutaneous ossification. She was a short, round-faced and stocky woman. Her hands and feet were stubby. These appearances, so-called Albright's hereditary osteodystrophy (AHO), including cutaneous calcification and ossification are also known to be the features of pseudo pseudohypoparathyroidism (PPH), in which serum Ca and P levels are normal. Therefore cutaneous calcification and ossification cannot be explained by hypocalcemia and hyperphosphatemia. These physical characteristics are

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