Endocrine Abstracts

Introduction

Amicrobial skin pustulosis is one of the exceptional manifestations of hypoparathyroidism. We report 2 observations of a Fahr syndrome secondary to hypoparathyroidism revealed by generalized pustulosis.

Observations 1

24 year old woman, with no history of thyroid surgery, The patient was admitted for generalized covering more than 90% of the body surface. Biology objected to hypocalcemia at 57 mg/l, hyperphosphatemia at 66 mg/l and parathyroid hormone at 2.9 pg/ml. Fahr’s syndrome was confirmed on a brain tomodensitometry conveyed bilateral calcifications of the central gray nucleus. The ophthalmologic examination revealed a bilateral posterior subcapsular cataract.

Observations 2

A 47-year-old woman, without the notion of thyroidectomy. The patient was admitted for a diffuse pustular rash. Biology objected : hypocalcemia at 39 mg/l, hyperphosphatemia at 69 mg/l and parathyroid hormone at 3 pg/ml. The brain tomodensitometry conveyed bilateral calcifications of the central gray nucleus. The diagnosis of Fahr syndrome on hypoparathyroidism was retained. The two patients were treated with intravenous calcium 8 g/d and with alfacacidol 3 μg/d magnesium 600 mg/d orally. The evolution of the 2 patients was marked by the disappearance of more than 95% of the lesions, concomitant with the correction of calcium levels.

Conclusion

The dermatological expression of Fahr syndrome secondary to hypoparathyroidism has been rarely reported in the literature, which should be considered in the presence of any skin pustulosis.