Pilonidal sinus of atypical areas: presentation and management

Abstract

Introduction: Pilonidal sinus (PNS) is an inflammatory disorder due to hair penetrating the epidermis. It occurs usually in sacro-coccygeal region. Clinical course and management of PNS in atypical areas has never been addressed in a systematic review. Methods: Google scholar was used to identify articles describing pilonidal sinus in any place other than the sacro-coccygeal area. Results: From 37 papers, there were reports of 302 cases of pilonidal sinus occurring in various sites other than sacro-coccygeal area. 253 cases (85%) were male. The age of presentation ranged from 16 to 70 years with average of 24.3 years. The most common atypical sites of pilonidal sinus was umbilicus (91%), followed by hand (4%). Conclusion: Umbilical PNS is the most common one. Pain, swelling and discharge is the usual presentation. Apart from umbilical PNS which is mostly managed conservatively, PNS of atypical sites is managed by excision and primary repair.