A morbidly obese female with a body mass index of 39 and without a past medical history of skin or connective tissue disorders was taken to the operating room for a laparoscopic Roux-en-Y gastric bypass, utilizing the methylene blue leak test. On the following day, she developed significant blancheable bluish skin discoloration on her bilateral fingers and palms without sensory changes. The rest of her postoperative course was otherwise uneventful. In this article, we describe an unusual dermatologic change related to the use of methylene blue during bariatric surgery.
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