Background: PASH syndrome (pyoderma gangrenosum, acne, and Hidradenitis suppurativa) is a rare autoinflammatory disorder within the spectrum of neutrophilic dermatoses. Early recognition is essential due to its chronic course and variable therapeutic response.

Clinical Cases: We describe two adult male patients who presented the characteristic triad. The first case showed arefractory course despite conventional therapies and tumor necrosis factor (TNF) inhibitor therapy, with histopathological confirmation. The second case presented with lower-limb pyoderma gangrenosum associated with cicatricial acne and Hurley stage III hidradenitis suppurativa, showing favorable response to systemic corticosteroids.

Conclusions: These cases highlight the relevance of PASH syndrome in the differential diagnosis of neutrophilic dermatoses. Early diagnosis allows individualized therapeutic strategies and may improve clinical outcomes.