Pilonidal cyst
Background
- Sinus is formed by penetration of skin by ingrowing hair
- Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infxn
- Carcinoma is rare complication of chronic, recurring pilonidal sinus disease
Diagnosis
- May present as a painless cyst, acute abscess, or recurring cysts w/ 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
DDX
- Anal fistula
- Syphilitic and tuberculous granulomas
- Simple furuncles
- Fungal infection
- Sacral osteomyelitis
Treatment
- I&D
- Abx only needed if cellulitis is present
- Refer to surgeon for recurrent disease
Source
Tintinalli