A case of canine cutaneous pyogranuloma in German Shepherd. The results from histopathologic examination confirmed the disease, although secondary bacterial infection, cutaneus lymphoma, vasculitis, erythema multiforme, even mastocytoma had been suspected by reffering veterinarian. On physical examination of the dog, mild lymphadenopathy was observed, and dermatological examination revealed papules, not painful on palpation. Multiple deep skin scrapings were negative for the presence of Demodex canis. Antibiotic and antifungal therapy was administrated without any improvement of the skin condition. The CBC result revealed mild leucocytosis with neutrophilia. Treatment for dog's skin condition involves surgery, dietary changes and medications. What's your way to manage this?