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Pilonidal Disease

Tam T. Nguyen, MD Reviewed 05/2023
 


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, fever is rare

  • Acute abscess: severe pain, swelling, discharge from the top o...

TREATMENT

GENERAL MEASURES

  • Shave hair area; remove hair from crypts weekly.

  • Asymptomatic disease does not need surgical treatment.

MEDICATION

  • Antibiotics not indicated unless there is significant cellulit...

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 Microb...

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

SNOMED

  • 432863009 pilonidal disease (disorder)

  • 4...

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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