A 23-year-old white woman presented with a 2-month history of a pyoderma gangrenosum–like ulcer in the right postauricular region. The cutaneous lesion had initially started as a pustule that was associated with local pain, subfebrile temperature, night sweats, and spontaneous perforation with a whitish discharge 2 weeks after the disease onset. Necrectomy was performed, and antibiotics (clindamycin, amoxicillin and clavulanate potassium [co-amoxiclav], and azithromycin) were administered intravenously in an outpatient clinic, without success.