Pilonidal disease

Pilonidal disease is a chronic, suppurative condition most commonly involving the natal cleft that typically affects young men.

It is an acquired disease in which loose hairs trapped within the natal cleft penetrate the skin leading to a granulomatous foreign body reaction. As a result, midline pits within the natal cleft and chronic sinus tracts may develop.

Pilonidal disease may be asymptomatic or present with an acute abscess or a chronic cyst and/or sinus with persistent drainage.

Asymptomatic disease does not mandate treatment. An acute pilonidal abscess should undergo drainage, ideally unroofing and curettage. Conservative (nonsurgical) treatments for chronic pilonidal disease have yielded mixed reports of success. Currently, there is no consensus on the optimal surgical treatment and many different techniques are available. Complications of tissue healing and recurrence are frequent.

Pilonidal disease is an acquired, chronic, suppurative condition most commonly involving the natal cleft. Pilonidal disease is caused by the forceful insertion of loose hairs trapped within the natal cleft through the skin, creating a granulomatous foreign body reaction that may result in the formation of midline pits and chronic sinus tracts. The spectrum of disease presentation varies from asymptomatic to an acute abscess or a chronic cyst and/or sinus tract with persistent drainage.