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Background: Erythrodermic psoriasis is a severe manifestation of psoriasis and can be triggered by several factors., Case Report: A 35-year-old man was admitted with severe, almost generalized exfoliative, oozing erythrodermic psoriasis, fever, and cramping of hands and legs. He was under systemic treatment with acitretin. Laboratory examination revealed a marked hypocalcemia as a consequence of primary hypopara thyroidism as well as hypalbuminemia. After normalization of the serum calcium and albumin levels, cutaneous symptoms and fever rapidly improved. No infectious etiology could be found. Hypoparathyroidism together with a right-sided aorta was caused by a 22q11 deletion syndrome., Conclusion: Epidermal cell proliferation and formation of intercellular junctional components of the epidermis are strongly calcium-dependent. Furthermore, carriers like albumin are necessary for the transportation of acitretin in the peripheral tissue. This case report suggests that calcium can be involved in psoriasis pathogenesis at least in a subgroup of patients and that systemic retinoids exhibit insufficient effectiveness under low serum albumin levels.

A report on two siblings, on formula feeding, who had fits in the second week of life. Cause of the hypocalcemic cramps was a formerly undetected hyperparathyroidism in the mother.

Out of five children with hypercalciuria, four had nephrocalcinosis and one recurrent bladder calculi. Two out of four patients with nephrocalcinosis (patients 1 and 2) had the "hyperprostaglandin E syndrome" and the other two (patients 3 and 4, siblings) had the Royer syndrome (osteopathy, dwarfism, secondary hyperparathyroidism). Treatment with hydrochlorothiazide is effective in patients without increased urinary excretion of prostaglandin, whereas patients with increased prostaglandin excretion respond better to indomethacin therapy.