Nonhealing abdominal ulcer after robotic sleeve gastrectomy

A 47-year-old female with a past medical history of diabetes mellitus type II, obesity, and polyarthralgia, underwent robotic sleeve gastrectomy and presented with a rapidly expanding nonhealing abdominal ulcer at her laparoscopic site. The patient was referred to dermatology after failing 3 excisions. Ulcers were noted on distal edges of the most recent excision (Fig 1). Labs at presentation showed normal complete blood count and C-reactive protein, and erythrocyte sedimentation rate was elevated.