Pyoderma gangrenosum presents with erythematous nodules or pustules which frequently ulcerate. It is a rare disease and its exact etiology is unknown but it is suspected to be an autoimmune disease. The ulcerations begin as small, quick-spreading reddish-purple colored bumps or blisters and eventually become swollen and ulcerated with a typical bluish black undermined edge. The ulcerations can spread and may even become extremely painful. Although their cause is unknown, these ulcerations can also occur in association with certain diseases especially inflammatory bowel disease. Other associations include rheumatoid arthritis, multiple myeloma and leukemia. Image source: dermnetnz.org