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Pilonidal Disease

Tam Nguyen, MD, FAAFP Reviewed 06/2018
 


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

  • 16 to 26/100,000 per year

  • Predom...

DIAGNOSIS

HISTORY

Three distinct clinical presentations 
  • Asymptomatic: painless cyst or sinus at the top of the gluteal cleft

  • Acute abscess: severe pain, swelling, discharge from the top of the gluteal c...

TREATMENT

GENERAL MEASURES

Shave area; remove hair from crypts weekly. 

MEDICATION

  • Antibiotics not indicated unless there is significant cellulitis (1)

  • If antibiotics are needed, a culture to direct thera...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Frequent dressing changes required after I&D

  • Follow up wound checks to assess for recurrence.

Patient Monitoring

Monitor for fever; more extensive cellulitis 

PATIENT EDUCATION

REFERENCES

1
Mavros MN, Mitsikostas PK, Alexiou VG, et al. Antimicrobials as an adjunct to pilonidal disease surgery: a systematic review of the literature. Eur J Clin Microbiol Infect Dis.  2013;...

ADDITIONAL READING

  • Aygen E, Arslan K, Dogru O, et al. Crystallized phenol in nonoperative treatment of previously operated, recurrent pilonidal disease. Dis Colon Rectum.  2010;53(6):932–935. [V...

CODES

ICD10

  • L05.91 Pilonidal cyst without abscess

  • L05.92 Pilonidal sinus without abscess

  • L05.01 Pilonidal cyst with abscess

  • L05.02 Pilonidal sinus with abscess

ICD9

  • 685.1 Pilonidal cyst without mention of a...

CLINICAL PEARLS

  • Avoid prolonged sitting.

  • Lose weight.

  • Trim hair in gluteal cleft weekly.

  • Refer recurring infections for more definitive surgical management.

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