BACKGROUND: Pyoderma gangrenosum (PG) is an uncommon neutrophilic dermatosis typically characterized by painful cutaneous ulceration's with hermorrhagic and purulent crust. PG has several different variants that often delay correct diagnosis. Clinical appearance and histopathology should suggest the diagnosis and exclude other diseases with similar ulceration's. The course of the disease is variable, often chronic, and occasionally severe and progressive. PG is frequently associated with other inflammatory diseases, most often inflammatory bowel disease and rheumatoid arthritis. Management can be challenging, with immunosuppression as the mainstay of treatment.