A New York restaurateur, Millie Graff, is followed home from work by a man who forces her into her apartment and tortures her before killing her. She is found with her hand wrapped around a silver cross on a necklace. She's been gagged, sexually violated and then skinned alive. As Quinn and his associates follow the path of the killer known as 'The Skinner', another woman's desperate search for the truth will bring her into the crosshairs of a killer with a burning desire to settle old scores. Quinn and Pearl must rush to Missouri to confront the monster before yet another life is lost.