Pilonidal Disease
Pilonidal means “nest of hair”. Pilonidal disease refers to an abscess, cyst or sinus in the intergluteal cleft, often containing hair or other debris. They commonly occur along the posterior supreior gluteal cleft. Caused by hair becoming entrapped in the follicle triggering an inflammatory response (by sitting and moving around). Diagnosis is clinical.
Common between puberty and 35 years of age. More common in men. Rare after 40 years of age.
- Signs and symptoms
- Painful fluctuant mass in the sacrococcygeal region
- Local erythema and cellulitis
- Visible sinus tract moving upwards that drains pus
- Treatment
- Hair control around the area: weekly shaving or other hair removal techniques
- Incision and Drainage
- Short term antibiotic for residual skin infection (1st gen cephalosporin, or something to cover gram positives)
- Treat sinus tracts with further surgery: wide excision, curettage, marsupialization, excisions with rotational flaps
