Pyoderma gangrenosum (PG) is a rare, painful, non-infectious, ulcerative, inflammatory skin condition. Clinicians need to be aware of PG because if the condition is incorrectly managed, it can lead to extensive tissue damage. Diagnosis is made largely on clinical appearance, from the patient history and from the exclusion of other possible diagnoses. Management requires a multidisciplinary approach as systemic therapies are often required to avoid the spread of the disease and to achieve wound healing. PG is often associated with underlying systemic disease, but can also be found in isolation, as the case study in this article highlights.