It involves elevated cytokines like TNF-α and interleukins (IL-1α, IL-17, IL-23), leading to cutaneous ulcers.1, 2 PG is often associated with systemic conditions such as rheumatoid arthritis, inflammatory bowel disease, and myelodysplastic neoplasms/syndrome (MDS), particularly in cases with trisomy of chromosome 8.3 The gene discussed is IL1A; the disease is myelodysplastic syndrome.