Thanks for your query at HCM! I am Infectious Disease Specialist! I went through your query! The first-line treatment for disseminated or localized pyoderma gangrenosum is systemic treatment by corticosteroids and immunosuppressive agents like cyclosporine. Topical application of Clobetasol, Mupirocin, and Gentamicin alternated with Tacrolimus could be beneficial. Papules that begin as small spouts can be treated with Dakins Solution to prevent infection and entire wounds cluster also benefit from this disinfectant. Wet to dry applications of Dakins can defeat spread of interior infection. Heavy drainage can be offset with Coban dressings. Grafting is not recommended due to tissue necrosis. If ineffective, alternative therapeutic procedures include systemic treatment with corticosteroids and mycophenolate mofetil; mycophenolate mofetil and cyclosporine; tacrolimus; thalidomide; infliximab; or plasmapheresis. Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query. Take care! Dr. Sheetal Verma Infectious Disease Specialist