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Pilonidal cyst
From WikEM
Contents
Background
- Sinus is formed by penetration of skin by ingrowing hair
- Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infectionn
- Carcinoma is rare complication of chronic, recurring pilonidal sinus disease
Clinical Features
- 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
- Anal tags
- Hemorrhoids
- Cryptitis
- Anal fissure
- Anal fistula
- Anorectal abscess
- Proctitis
- Rectal prolapse
- Rectal foreign body
- Pruritus ani
- Pilonidal cyst
- Constipation
- Condyloma acuminata
- Anal cancer
- Colorectal tumor
- Pedunculated polyp
- Crohn Disease
- Syphilitic fissure
- GC/Chlamydia
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
- ↑ Rosen's 7th Ed
