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[Light and scanning electron microscopy study of the pathogenesis of pilonidal sinus and anal fistula]
1Chirurgische Universitätsklinik und Poliklinik, Bonn Venusberg, BRD.
Abstract:
From various theories about the development of the pilonidal sinus Stelzner's opinion as to an acquired disease is generally accepted. Our scanning electron microscopic investigations strengthen this theory that hair splits and drills into the skin. Hooks keep it from retracting. Needlelike sharp ends may contribute to the hair piercing the skin. The anal fistula differs from the pilonidal sinus concerning morphology and pathogenesis. Surgical treatment must consider the localisation of the proctodeal gland.
Insights
Pilonidal sinus is an acquired disease, supported by evidence that hair splits and penetrates the skin. Microscopic analysis reveals hair hooks and sharp ends facilitate this process, differentiating it from anal fistulas.
Area of Science:
- Dermatology
- Pathology
- Surgical Anatomy
Context:
- Pilonidal sinus disease is a common condition with debated etiology.
- Stelzner's theory of acquired disease is widely accepted.
- Understanding pathogenesis is crucial for effective treatment.
Purpose:
- To investigate the role of hair in pilonidal sinus formation using scanning electron microscopy.
- To differentiate pilonidal sinus from anal fistulas based on morphology and pathogenesis.
- To highlight considerations for surgical treatment of pilonidal sinus.
Summary:
- Scanning electron microscopy supports the theory that pilonidal sinus is acquired.
- Hair shafts, with split ends and hook-like structures, penetrate the skin.
- Anal fistulas have distinct morphology and pathogenesis compared to pilonidal sinuses.
Impact:
- Provides strong microscopic evidence for the acquired nature of pilonidal sinus.
- Clarifies the mechanism of hair penetration into the skin.
- Emphasizes the importance of anatomical considerations, specifically the proctodeal gland, in surgical interventions for pilonidal sinus and anal fistulas.