INTRODUCTION: Interdigital pilonidal sinus is an acquired condition secondary to penetration of hair fragments into the skin of the web spaces of the hands commonly observed in hairdressers, and occasionally, among pet groomers. Local literature reports or guidelines to ensure practice of protective measures for this population of workers are currently lacking. CASE SUMMARY: A 24-year old pet groomer consulted due to occasional white hair strands emerging from two openings in the third interdigital space of his dominant hand. Histopathologic examination of the sinus tract showed an acanthotic, hyperplastic epidermis with scale crust, and nodular dermal infiltrates composed of epithelioid histiocytes, plasma cells, lymphocytes, and eosinophils. Transepidermal extrusion of polarizable hair cortical material was also evident establishing the diagnosis of an interdigital pilonidal sinus. Sinusectomy and debridement with healing by secondary intention resulted in an optimal wound closure and full motion of the affected hand after one week and minimal scarring with no recurrence after seven months. CONCLUSION Surgical excision followed by proper wound care is essential to avoid recurrence. In conclusion, since interdigital pilonidal disease is a rare condition, awareness among physicians would lead to accurate diagnosis, optimal treatment, and proper patient education.
occupational diseases ; grooming ; extremities ; Pilonidal sinus

PURPOSE: Recurrence of a pilonidal sinus after surgery is well known. Many surgical techniques have been developed but there is no efficient method available. This study evaluated the results of a Modified Rhomboid excision and Limberg flap of a pilonidal sinus, and examined the value of this method. METHODS: Five patients, who had been treated with a modified rhomboid excision and Limberg flap procedure for recurrent pilonidal sinus, were evaluated. The patient's age, gender, duration of symptoms, length of hospital stay, complications, time required for the return to normal activity, and prior history of surgery were evaluated. RESULTS: The mean age of the 5 patients (4 males and 1 female) was 22.7 years, and all had a history of previous surgery. The mean duration of symptoms was 4.2 years. Only one patient developed seroma. The mean hospital stay was 7.2 days, and the mean time to normal activity was 14.4 days. There was no recurrence. CONCLUSION: Modified Rhomboid excision and Limberg flap procedure is the optimal method for treating recurrent pilonidal sinus with low complication and recurrence rates.
Humans ; Length of Stay ; Male ; Pilonidal Sinus ; Recurrence ; Seroma

PURPOSE: Recurrence after surgery for the pilonidal sinus is well known. Many operative techniques have been developed, but an efficient method has not yet been developed. The aim of this study was to evaluate the results of a wide excision and simple primary closure of the pilonidal sinus, and to assess the usefulness of this method. METHODS: The patient's age and sex, duration of symptoms, length of hospital stay, complications, recurrence rate, time required for the return to normal activity, and past history of surgery were evaluated. RESULTS: The mean age of 42 patients was 21.2 years, 41 of these patients were male. 15 patients had a histoty of a previous operation. Twelve had a history of an incision and drainage, and 3 had a history of an excision. The mean duration of the symptoms was 3.5 years. Six among the 42 patients suffered from a complication, and there was only 1 case of recurrence. CONCLUSION: A wide excision and a simple primary closure of the pilonidal sinus is an easy, simple method and the recurrence rate is also low. Therefore, it is still a desirable method of treatment for the pilonidal sinus.
Drainage ; Humans ; Length of Stay ; Male ; Pilonidal Sinus* ; Recurrence

The cause of a pilonidal cyst is unclear, and treatment is still under debate. In Korea, the incidence of this disease is lower than that of Western countries, and it has often been misdiagnosed as a simple abscess. When pilonidal cysts are diagnosed, the principle of treatment is not to leave a residue, and a wide excision is needed to reduce the recurrence rate. This paper introduces a wide excision technique using Indigo-carmine dye to minimize the recurrence of a pilonidal cyst.
Abscess ; Incidence ; Korea ; Pilonidal Sinus ; Recurrence ; Sacrococcygeal Region

Sacrococcygeal pilonidal disease(SPD) is an acquired disease intimately related to the presence of hair in the gluteal groove. Although its pathogenesis is still controversial, numerous treatment options are available for SPD including gluteal groove and surrounding skin hair removal, sinusectomy, open healing by secondary intention, primary closure, and local excision with flap reconstruction. Lacking of standardized diagnosis and treatment processes of SPD in China, Chinese Medical Doctor Association Anorectal Branch and its Clinical Guidelines Committee jointly organized experts in this field to form expert consensus opinion on the basis of summarizing latest research progress in China and abroad, experts' clinical experience and principles of evidence-based medicine. The expert group formed opinion in 12 terms of SPD diagnosis, risk factors, non-surgical treatment, surgical treatment, minimally invasive treatment, and wound management, and developed the "Chinese expert consensus on the diagnosis and treatment of sacrococcygeal pilonidal disease (2023 edition)" after rounds of discussion and revision, to improve the diagnosis and treatment of SPD.
Humans ; Consensus ; Surgical Flaps ; Wound Healing ; China ; Pilonidal Sinus/surgery*

Pilonidal sinus is one of a follicular occlusion tetrad, and is a chronic inflammatory disease that is associated with hair; a midline hairy patch or pit in the sacral region with a sinus orifice in the bottom, or a cyst beneath it, in which hair is growing. The exact pathogenesis of pilonidal sinus remains unknown, but hair insertion may be the essential cause of the disease. It is usually treated by radical excision, marsupialization or incision and curettage. However, these surgical options often lead to a high recurrence rate, especially for hirsute patients. Wide excision and simple primary closure of the pilonidal sinus is an easy, simple method and the recurrence rate is low. We report here the case of an 18-year-old male patient with recurrent pilonidal sinus mimicking inflammatory epidermal cyst. The pilonidal sinus was treated by wide excision and primary closure.
Adolescent ; Curettage ; Epidermal Cyst ; Hair ; Humans ; Male ; Pilonidal Sinus ; Recurrence ; Sacrococcygeal Region

PURPOSE: The aim of this study was to compare two different treatment methods for pilonidal sinus with respect to complications, recurrence, and patient quality of life. METHODS: Five hundred forty-nine patients who underwent surgery for pilonidal sinus between January 2007 and August 2012 were included in this study. The patients were classified into group I (excision and primary closure) and group II (Limberg flap). RESULTS: There was no significant difference in the mean age and gender of the patients between groups I and II (P = 0.512 and P = 0.472). The duration of surgical operation was lower in group I (P < 0.001). There was no significant difference in hospitalization time after surgery, minor complications, and recurrence between the groups (P = 0.674, P = 1.000, and P = 1.000, respectively). The time required for pain-free walking, urinating, and returning to work was significantly lower in group II (P < 0.001, P < 0.001, and P < 0.001, respectively). The patients in group I stated that they were more satisfied in terms of aesthetics (P < 0.001). CONCLUSION: According to the results of this study, Limberg flap method has better outcomes compared with excision and primary closure. Therefore, we recommend Limberg flap for treatment of pilonidal sinus disease.
Esthetics ; Hospitalization ; Humans ; Oxalates ; Pilonidal Sinus* ; Quality of Life* ; Recurrence ; Surgical Procedures, Minor ; Walking

PURPOSE: Pilonidal sinus is a frequent disease that occurs mostly in hairy young men, defined as chronic inflammation and infection of the postsacral sinuses. Wide excision of the affected area is the treatment of choice. Many techniques have been described to cover the defect. However none appears to be the ideal procedure to prevent infection, recurrence, and delayed wound healing. We present the results of an alternative technique that we performed by using partial deepithelized gluteal transposition flap for reconstruction of the defect following wide excision. METHODS: From October 2004 to September 2007, we performed the partial deepithelized gluteal transposition flap method on 6 patients. We modified the transposition flap techniques by deepithelialising the medial parts of the flap and burying them under the opposing edge of the flap. The results were compared with previous studies and evaluated regarding duration of surgery, size of defect, hospitalization periods, and complications. RESULTS: All the flaps were healed well with no partial or complete loss of the flap. Hospitalization and immobilization periods were acceptably shortened. Recurrence was not seen. The aesthetic outcome was also satisfactory and all patients were satisfied with the results. CONCLUSION: The main advantage of our techniques is using healthy tissues to obliterate the dead space, to provide an extra-cushion, and to prevent deep dehiscence. We believe that the partial deepithelized gluteal transposition flap is a good alternative method for treatment of pilonidal sinus.
Hospitalization ; Humans ; Imidazoles ; Immobilization ; Inflammation ; Male ; Nitro Compounds ; Pilonidal Sinus ; Recurrence ; Wound Healing

PURPOSE: The purpose of this study is to evaluate the characteristic MR findings of sacrococcygeal pilonidal sinus. MATERIALS AND METHODS: Eight MR images of pathologically proven sacrococcygeal pilonidal sinus were retrospectively reviewed [M: F = 7: 1; age range 9-41 (median, 17) years]. In all cases, a sacrococcygeal mass was present. Five of the eight patients experienced pain, and in three was discharge. MR findings were evaluated with regard to the location and extent of the lesion, and the presence of sinus or cyst, and the results were compared with the pathologic findings. RESULT: According to the clinical manifestations, each case was assigned to one of four groups: the first type (n= 3) showed dermal thickening with subcutaneous fatty infiltration of the ipsilateral natal cleft while pathologically, a follicular cyst with dermal fibrosis and multiple fatty lobules with fibrous septa were found to be present. In the second type (n = 3), fluid was observed in the sinus tract, while the pathologic findings demonstrated the presence of an abscess in this area. In the third type (n = 1), a cystic lesion with airfluid level was present; pathologically, an abscess was revealed. The fourth type (n = 1) showed only a low signal intensity sinus tract on both T1 and T2-weighted images, while the pathologic findings indicated the presence of hairs and follicles within the tract. CONCLUSION: The MR findings of sacrococcygeal pilonidal sinus depend on the clinical manifestation and include subcutaneous fatty infiltration, a sinus tract with or without fluid retention, and a cystic lesion with air fluid level. These findings could be helpful for differentiating between this and other sacrococcygeal lesions.
Abscess ; Fibrosis ; Follicular Cyst ; Hair ; Humans ; Magnetic Resonance Imaging* ; Pilonidal Sinus* ; Retrospective Studies

Pilonidal sinus is a chronic inflammatory disease that is associated with hair; a midline hairy patch or pit in the sacral region with a sinus orifice in the bottom, or a cyst beneath it, in which hair is growing. Also, it is considered to belong in the category of follicular occlusion tetrad. It sometimes becomes inflamed, resulting in a subcutaneous abscess with recurrent infection. It becomes symptomatic during adolescence and presents as a foreign body abscess, with hair as the offender. Histological findings show follicular hyperkeratosis of the infundibulum with plugging and dilatation of follicle. Infiltration of hair occurs in one half of the specimens. Also, inflammatory cells are gathering to meet the challenge. The recommended treatment has been surgical excision of the lesion.
Abscess ; Adolescent ; Criminals ; Dilatation ; Foreign Bodies ; Hair ; Humans ; Pilonidal Sinus* ; Sacrococcygeal Region