Thank you for your inquiry.
No, I am afraid that the patient you described does not “ring any diagnostic bell.” She does not appear to have any of the classical “primary immunodeficiency disorders” as described in a very comprehensive review of primary immunodeficiency (Bonilla FA. Practice Parameter for the Diagnosis and Management of Primary Immunodeficiency. Annals of Allergy, Asthma, and Immunology 2005; 94(5) Supplement 1:S1-S63.
A defect such as you described would be most likely explained by an abnormality in neutrophil function or adhesion, but again, the symptoms do not suggest any of those of which I am aware that are commonly considered primary leukocyte-related immunodeficiency disorders.
However, there are other causes of poor wound healing. Here is an excellent review of this issue. It is of note that obesity itself is a cause, and there are other systemic causes discussed in this review as well.
In summary, I do not believe any further immunologic workup would be helpful in regards to this patient, but you might be able to assist her with nutrition or find other factors (such as smoking, for example) that are mentioned in the article which can be obtained by going to the above mentioned link.
Thank you again for your inquiry and we hope this response is helpful to you.
Phil Lieberman, M.D.