Which is not a feature of pilonidal sinus:
"Recurrence is common, even though adequate excision of the track is carried out." - Bailey & Love "Once an acute episode has resolved, recurrence is common"- Schwartz 9/e p1067
Pilonidal disease
Pilonidal disease consists of a hair-containing abscess or chronic sinus, occurring in the intergluteal cleft.
It is an acquired disease
Although earlier it was thought to be a congenital disease, it is now considered to be an acquired infection of natal cleft hair follicles. The hair follicles become infected and rupture into the subcutaneous tissues to form a pilonidal abscess. Hair from surrounding skin is pulled into the abscess cavity by the friction generated by the gluteal muscles during walking.
More common in males
The incidence of pilonidal disease is more common in males (3:1 male: female ratio) between ages 15 & 40 with peak incidence between 16 & 20 yrs.
Pilonidal ds is more common in people with more body hair (hirsute). The ds. is almost rare in persons with less body hair.
Treatment of choice is surgery
Pilonidal sinus should be excised along with the secondary openings. (But only after controlling acute infection).
Acute pilonidal abscesses and sinus ds can be managed by simple incision and drainage (under local anesthesia).
Branching tracts are common
Recurrence is uncommon
Bony involvement is uncommon
Seen in Drivers