Pilonidal Disease

Pilonidal Disease is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --

Basics

Description

  • Pilonidal disease results from an abscess, or sinus tract, in the upper part of the natal (gluteal) cleft.
  • Synonym(s): jeep disease

Epidemiology

Incidence
  • 16 to 26/100,000 per year
  • Predominant sex: male > female (3 to 4:1)
  • Predominant age: 2nd to 3rd decade, rare >45 years
  • Ethnic consideration: whites > blacks > Asians

Prevalence
Surgical procedures show male: female ratio of 4:1, yet incidence data are 10:1.

Etiology and Pathophysiology

Pilonidal means “nest of hair”; hair in the natal cleft allows hair to be drawn into the deeper tissues via negative pressure caused by movement of the buttocks (50%); follicular occlusion from stretching and blocking of pores with debris (50%)

  • Inflammation of SC gluteal tissues with secondary infection and sinus tract formation
  • Polymicrobial, likely from enteric pathogens given proximity to anorectal contamination
Genetics
  • Congenital dimple in the natal cleft/spina bifida occulta
  • Follicular-occluding tetrad: acne conglobata, dissecting cellulitis, hidradenitis suppurativa, pilonidal

Risk Factors

  • Sedentary/prolonged sitting
  • Excessive body hair
  • Obesity/increased sacrococcygeal fold thickness
  • Congenital natal dimple
  • Trauma to coccyx

General Prevention

  • Weight loss
  • Trim hair in/around gluteal cleft weekly.
  • Hygiene
  • Ingrown hair prevention/follicle unblocking

-- To view the remaining sections of this topic, please or purchase a subscription --