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SUMMARY Three cases of vascular calcification, cutaneous gangrene and hyperparathyroidism are presented. Biopsy of the skin reveals calcinosis of the media as well as obstruction of a muscular vessel. Secondary, as well as primary, hyperparathyroidism is associated with this characteristic cutaneous syndrome. Treatment of the parathyroid disease and conservative skin therapy will produce reversal of vascular calcification and healing of the skin.