Pilonidal Sinus

Question 1

Def

Answer 1

Hair follicle in growth and subsequent foreign body reaction

Question 2

Presentation

Answer 2

Asymptomatic
Abscess - pain, swelling, redness
Carcinoma

Question 3

Risk Factors

Answer 3

1. Obesity
2. Prolonged exercise
3. Lack of exercise
4. Hair around buttock region

Question 4

Ddx

Answer 4

Dermoid Cysts
Teratoma

Question 5

Management

Answer 5

• Conservative – shaving / laser epilation & hygiene, hot compress, antibiotics
• Abscess: I&D, 60% of patient will heal without need for further surgical intervention
• Surgical Treatment of Choice: Wide Excision with flap closure (i.e. Karydakis) +/- hair removal to prevent recurrence
• Recurrent: complete sinus excision with primary closure / healing by secondary intention and obliteration of natal cleft either by
  myocutaneous rotational buttock flap or cleft closure