Pseudopseudohypoparathyroidism (PPHP) is an inherited disorder, named for its similarity to pseudohypoparathyroidism in presentation. It is more properly Albright hereditary osteodystrophy although without resistance of parathyroid hormone as frequently seen in that affliction. The term Pseudopseudohypoparathyroidism is used to describe a condition where the individual has the phenotypic appearance of Pseudohypoparathyroidism type 1a, but has (unexpected for the phenotype) normal labs including calcium and PTH.It can be considered a variant of Albright hereditary osteodystrophy, or Pseudohypoparathyroidism type 1A, as they present with the same constellation of signs and symptoms, including short stature, brachydactyly, subcutaneous calcification, and obesity. Presentation
Pseudopseudohypoparathyroidism can be best understood by comparing it to other conditions:

Hormone resistance is not present in Pseudopseudohypoparathyroidism. Short stature may be present. Obesity is less common in Pseudopseudohypoparathyroidism  than in Pseudohypoparathyroidism. Osteoma cutis may be present. Genetics
A male with Pseudohypoparathyroidism has a 50% chance of passing on the defective GNAS gene to his children, although in an imprinted, inactive form. Any of his children receiving this gene will have Pseudopseudohypoparathyroidism. Any of his daughters that have Pseudopseudohypoparathyroidism may in turn pass along Pseudohypoparathyroidism 1A to her children as the imprinting pattern on the inherited paternal gene will be changed to the maternal pattern in the mothers ovum during meiosis. The gene will be reactivated in any children who inherit it.Pseudopseudohypoparathyroidism and pseudohypoparathyroidism both involve the same GNAS gene, but Pseudopseudohypoparathyroidism has normal calcium homeostasis because of the normal maternal allele in the kidney.
Acne miliaris necrotica is a rare condition consisting of follicular vesicopustules, sometimes occurring as solitary lesions that are usually very itchy. The condition affects middle aged and elderly individuals. Affected areas can include the scalp, frontal hairline, face, and chest. Causes
It has been hypothesized that the body overreacts to an organism such as the S. aureus bacterium. Diagnosis
Treatment
There are multiple medications that are able to treat acne varioliformis. Topical
Clindamycin 1% lotion or Benzoyl peroxide/clindamycin gel
Erythromycin 2% gel
1% hydrocortisone cream

Systemic
Doxycycline 50 mg twice daily
Isotretinoin 0.5 mg/kg daily

See also
List of cutaneous conditions

References


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