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Pyoderma gangrenosum is a rare neutrophilic dermatosis characterized by painful ulcerative skin lesions and a lack of definitive diagnostic tests. It is frequently mistaken for infectious conditions, often resulting in inappropriate antibiotic use and delayed immunosuppressive therapy. To describe the clinical and demographic characteristics of patients with pyoderma gangrenosum initially assessed in an infectious diseases setting and identify patterns that may aid in earlier diagnosis and management. A retrospective case series was conducted at a Cellulitis Clinic. Patients with a PARACELSUS score ⩾10 were included. Ten patients met inclusion criteria. Median age was 61.5 years; 60% were female and 90% Caucasian. Autoimmune diseases were present in 90%, mental health disorders in 50%, and endocrine abnormalities in 60%. Notably, 20% developed pyoderma gangrenosum at sites of healed scars-a rare presentation. Early recognition and multidisciplinary management are essential for timely treatment and improved outcomes.