Peristomal Ulcers

45yo quadriplegic male has developed wounds around urostomy. No significant medical hx besides spinal injury and kidney stones. Wounds started approx 6 years ago while hospitalized for flap surgery for pressure injury. New product was used around ostomy and wounds developed. Wounds increase and decrease in size but never close. First puc is most recent and second from several months ago. The Ulcers seem to start as red pauses and gradually open and spread in a crater-like form. Multiple wound treatments tried including silver, honey, steroids, collagen. Recent biopsy showed spongiosis and chronic inflammatory infiltrate with lymphocytes and eosinophils. Negative for bacteria, fungus, cancer, and pyroderma gangrenosum. Anyone know what this could be and how to treat?

Update 1

Convinced PCP to give trial of steroids and wound improved considerably which leads me to believe this is indeed PG.

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