Presentation of pseudohypoparathyroidism and pseudopseudohypoparathyroidism with skin lesions: Case reports and review.

We report three cases of patients with pseudohypoparathyroidism or pseudopseudohypoparathyroidism. These diseases are considered GNAS inactivating mutation syndromes that are characterized by a diversity of alterations among which a particular phenotype and specific endocrine or ossification abnormalities may be found. These patients may present with hard cutaneous nodules, which can represent osteoma cutis. The presence of these lesions in pediatric patients should prompt the dermatologist's consideration of this group of diseases when reaching a diagnosis. A multidisciplinary team of pediatricians, endocrinologists, geneticists, and dermatologists should carefully evaluate these patients.

[Utilization of dermatology services among the immigrant population]. / Análisis de la demanda asistencial en dermatología de la población inmigrante.

OBJECTIVE: To determine the utilization rate of a dermatology service among the immigrant population and compare this rate with that among the autochthonous population. METHODS: Over a 1-year period, data on all patients attended in the Dermatology Service of Health Department 19 in the autonomous community of Valencia were prospectively collected. RESULTS: Of 39,160 consultations, 1,625 were made by immigrants (4.1%). Attendance for dermatologic emergencies was greater in immigrants than in the autochthonous population (7.7% vs 3.0%; p<0.001), while surgical activity was lower in immigrants than in Spanish-born patients (2.6% vs 5%; p<0.001). Demand for consultation in the immigrant population was 5.7 visits per 100 immigrants, lower than that in the autochthonous population (16.2). The standardized rate ratio was 0.34. North Africans (5.6 per 100 immigrants), East Europeans (4.8), sub-Saharan Africans (5.3) and Asians (4.2) consulted less than Latin Americans (8.5; p<0.001). CONCLUSIONS: Demand was lower in the immigrant than in the autochthonous population, and the utilization pattern differed according to country.