Pilonidal cyst - Anogenital in
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Synopsis
Initially, pilonidal disease was believed to be congenital in nature and to represent a type of dermoid cyst. Current belief is that this is caused by excessive repetitive trauma to the sacrococcygeal region, illustrated by the prevalence of this problem among Jeep drivers in World War II (so called "Jeep disease").
Risk factors for pilonidal disease include male sex (adult), hirsutism, obesity, occupations requiring extended periods of sitting, and the presence of a deep natal cleft. Pilonidal cysts are more common in adolescence and young adulthood. Systemic signs and symptoms are rare.
"Barber's interdigital pilonidal sinus" refers to the reaction surrounding an entrapped cut or shaved hair, often seen in an interdigital space of a barber's hand. These cases represent foreign body granulomas rather than true cysts.
Codes
ICD10CM:L05.01 – Pilonidal cyst with abscess
L05.91 – Pilonidal cyst without abscess
SNOMEDCT:
47639008 – Pilonidal cyst
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Cellulitis or erysipelas
- Fournier gangrene
- Perianal abscess arising from the posterior midline crypt
- Perirectal abscess
- Hidradenitis suppurativa
- Carbuncle
- Furuncle
- Sacral osteomyelitis
- Anal fistula
- Coccygeal sinus
- Actinomycosis
- Syphilis
- Tuberculosis
- Cutaneous Crohn disease
- Pyoderma gangrenosum
- Ecthyma gangrenosum
- Presacral sinus or dimple
- Dermal sinus tract – Dermal sinuses are usually found above the gluteal cleft, while pilonidal disease is seen within the gluteal cleft.
- Congenital anomaly (ie, spina bifida occulta)
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Management Pearls
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Therapy
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References
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Last Reviewed:09/09/2021
Last Updated:09/09/2021
Last Updated:09/09/2021
Patient Information for Pilonidal cyst - Anogenital in
Overview
Pilonidal disease is the presence of a small indentation, a firm lump, or a skin infection in the crease of the buttocks near the tailbone.Hairs get trapped in a small indentation in this area, preventing drainage. This may then form a cyst or abscess. This can look like a swollen and red dimple or one or more large painful masses near the tailbone.
Recurrence is common.
Who’s At Risk
Pilonidal disease is more common in men than women. People who have thick hair, are obese, or have occupations requiring them to sit for long periods of time are more prone to pilonidal disease.Initially, pilonidal disease was believed to be something that a person was born with. Now it is believed that excessive repetitive trauma to the tailbone region causes this condition.
Signs & Symptoms
A pilonidal cyst can look like a swollen, red dimple or one or more large, painful masses near the tailbone.You may have fever, chills, and pain, as well as discharge or bleeding from the infected area.
Self-Care Guidelines
- There are no self-care options for pilonidal cysts. While waiting to see your doctor, you can try applying a moist, warm washcloth to the affected area. Take ibuprofen to help with the swelling and pain.
- Shaving the area can decrease the rate of recurrence.
When to Seek Medical Care
- Your pilonidal disease does not get better or if it worsens with self-care measures.
- You develop an unexplained lump and develop a fever.
Treatments
- Your doctor may drain the abscess or cyst and remove any hairs from the wound.
- The doctor may also prescribe antibiotics for an infection.
Pilonidal cyst - Anogenital in
See also in: Overview,Cellulitis DDx