PTH and pachyonychia congenita: It is possible that PC in SHPT has a more benign course and better outcomes compared to PC in PHPT: despite the malignant transformation that appears at the endpoint of the natural course of chronic PTH stimulation, various mechanisms, and interventions that interfere with the pathophysiology of the parathyroid gland (calcimimetics, vitamin D analogues, and increased FGF23) may contribute to a more indolent evolution.