Pilonidal Disease Definition
Pilonidal disease or pilonidal sinus is an acquired condition and seen in adult males. This is hardly seen in females. While sitting the buttocks move and hairs broken off by friction and collect in the cleft. When toilet paper is used hair entangled in fecal matter will also be swept into the cleft. Such loose hairs travel down the inter-gluteal furrow to penetrate the soft and moistened skin at that region or enter the open mouth of a sudoriferous gland. After the initial entry dermatitis and inflammation start around the loose hairs and once the sinus is formed, intermittent negative pressure of the area may suck other loose hairs in the pit.
This sinus extends into the sub-cutaneous tissue. Tuft of hair is always seen within such sinus embedded in granulation tissue.
Other places where sinus may be found are:
- Inter-digital cleft of men’s hair-dresser. In this case customer’s hair finds access through the inter-digital cleft.
- The axilla (armpits).
- The umbilicus.
- Inter-digital web of the foot of a worker in hair mattress factory.
- Face.
Contents: These are mainly
- hairs
- granulation tissue and
- Epithelial scales and debris.
The hairs are usually dead and are found lying loose in the sinus, embedded in the granulation tissue or buried deep in the mature scar tissue at the depth.
Symptoms of Pilonidal
- Pilonidal sinus is usually presented by males during third decade. It is rarely seen in people over the age of 40yrs. It is more common in males than in females in the ratio of approximately 6:1.
- This condition is more often seen in Jeep drivers and so pilonidal sinus is also called as ‘Jeep disease’.
- Patient presents with blood-stained discharge from this sinus. There may be secondary opening on either side of the middle or a little away from the main sinus.
- Pain and tenderness is often associated with due to recurrent infection.
Complications of Pilonidal Disease
- Abscess formation.
- Recurrent inflammation.
- Recurrence of sinus formation.
- Very rarely malignant degeneration may occur in this lesion.
Pilonidal Treatment
- Pilonidal sinus is excised along with its secondary openings. Such opening is performed after controlling infection. Local cleansing, local anti-septic dressing, administration of broad spectrum antibiotic along with rest should be given to control infection.
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