Pilonidal cyst: Difference between revisions

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==Background==
==Background==
*Sinus is formed by penetration of skin by ingrowing hair
*Sinus is formed by penetration of skin by ingrowing hair
**Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infection  
**Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infection  
*Carcinoma is rare complication of chronic, recurring pilonidal sinus disease
*Carcinoma is rare complication of chronic, recurring pilonidal sinus disease


==Clinical Features==
==Clinical Features==
[[File:Pilonidal abscess.jpg|thumb|Pilonidal abscess of buttox.]]
[[File:Pilonidal abscess.jpg|thumb|Pilonidal abscess of buttox.]]
*May present as a painless cyst, acute [[abscess]], or recurring cysts with draining sinuses
*May present as a painless cyst, acute [[Special:MyLanguage/abscess|abscess]], or recurring cysts with draining sinuses
*Occurs in midline in the upper part of the natal cleft
*Occurs in midline in the upper part of the natal cleft
**Does not communicate with the anorectum
**Does not communicate with the anorectum
**Because of proximity to anus can be confused for a perianal abscess
**Because of proximity to anus can be confused for a perianal abscess


==Differential Diagnosis==
==Differential Diagnosis==
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{{Anorectal DDX}}
{{Anorectal DDX}}
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==Evaluation==
==Evaluation==
*Clinical
*Clinical


==Management==
==Management==
*[[I&D]] - longitudinal incision lateral to sacral midline
 
*[[Antibiotics]] only needed if [[cellulitis]] is present
*[[Special:MyLanguage/I&D|I&D]] - longitudinal incision lateral to sacral midline
*[[Special:MyLanguage/Antibiotics|Antibiotics]] only needed if [[Special:MyLanguage/cellulitis|cellulitis]] is present
*Refer to surgeon for recurrent disease
*Refer to surgeon for recurrent disease
**40% recurrence rate
**40% recurrence rate
**Refer for follicle removal after acute inflammation subsides (~1 wk)<ref>Rosen's 7th Ed</ref>
**Refer for follicle removal after acute inflammation subsides (~1 wk)<ref>Rosen's 7th Ed</ref>


==See Also==
==See Also==
*[[Anorectal Disorders]]
 
*[[Special:MyLanguage/Anorectal Disorders|Anorectal Disorders]]
 


==References==
==References==
<references/>
<references/>
[[Category:GI]]
[[Category:GI]]
[[Category:Dermatology]]
[[Category:Dermatology]]
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Latest revision as of 23:52, 4 January 2026


Background

  • Sinus is formed by penetration of skin by ingrowing hair
    • Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infection
  • Carcinoma is rare complication of chronic, recurring pilonidal sinus disease


Clinical Features

Pilonidal abscess of buttox.
  • May present as a painless cyst, acute abscess, or recurring cysts with draining sinuses
  • Occurs in midline in the upper part of the natal cleft
    • Does not communicate with the anorectum
    • Because of proximity to anus can be confused for a perianal abscess


Differential Diagnosis

Anorectal Disorders

Non-GI Look-a-Likes


Evaluation

  • Clinical


Management

  • I&D - longitudinal incision lateral to sacral midline
  • Antibiotics only needed if cellulitis is present
  • Refer to surgeon for recurrent disease
    • 40% recurrence rate
    • Refer for follicle removal after acute inflammation subsides (~1 wk)[1]


See Also


References

  1. Rosen's 7th Ed