Pyoderma gangrenosum of the breast revealing contralateral breast carcinoma Dear Editor, Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis, regarded within the spectrum of autoinflammatory conditions. PG is commonly associated with inflammatory systemic diseases and hematological malignancies. 1,2 Previous literature exploring the association between PG and solid organ malignancy is mostly based on single case reports, making it difficult to establish a parallel between internal malignancy and PG. 3 In a recent review, the majority of paraneoplastic PG was reported before the diagnosis of the underlying tumor. The most common solid organ malignancies associated with PG were found on the breast. 2,4 We report a case of PG localized on the left breast preceding the diagnosis of a neoplasm of the right breast. To date, just one case of a breast PG portending the diagnosis of breast neoplasm has been reported in the literature. 5A previously healthy 79-year-old female patient presented with a 6-month history of painful ulceration on the lower quadrants and areola of the left breast, not improving under systemic antibiotic therapy. Previous attempts to excise the lesion were not successful. There was no history of surgery or previous trauma. She did not have any other symptoms.On physical examination she had an ulcerated lesion sparing the nipple with a slightly undermined violaceous border (Fig. 1a). No breast lumps or axillary lymph nodes were palpa-