Laboratory data revealed a white blood cell count 13.1 thousand/mm3, hemoglobin 8.6 mg/dl, blood urea nitrogen 52 mmol/l, creatinine 4.7 mmol/l (baseline creatinine around 5.0 mmol/l), calcium 10.4 mmol/l, albumin 2.2 gm/dl, phosphorus 8 mmol/l and a parathyroid hormone (PTH) level of 2138 pg/dl (with a level of 1381 pg/dL 6 months prior) On the fifth day of hospitalization, she started developing peridermal necrotic areas along with erythema and tenderness in her thigh (Figure 1). This evidence concerns the gene PTH and Erythema.