Pilonidal Disease was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.
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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
- 0.7%: 1.1% males, 0.1% females
- Predominant sex: Male > Female (3–4:1)
- Predominant age: 2nd–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.
Risk Factors
- Sedentary/Prolonged sitting
- Excessive body hair
- Obesity/Increased sacrococcygeal fold thickness
- Congenital natal dimple
- Trauma to coccyx
- Congenital dimple in the natal cleft/spina bifida occulta
- Follicular-occluding tetrad: Acne conglobata, dissecting cellulitis, hidradenitis suppurativa, pilonidal
General Prevention
- Weight loss
- Trim hair in/around gluteal cleft weekly
- Hygiene
- Ingrown hair prevention/follicle unblocking
Pathophysiology
Pilonidal = “nest of hair”; excoriation by 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%)
Etiology
- Inflammation of SC gluteal tissues with secondary infection and sinus tract formation
- Polymicrobial, likely from enteric pathogens given proximity to anorectal contamination
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