A different disease: extrasacrococcygeal pilonidal sinuses etiopathogenesis

Area of Science:

• Dermatology
• Surgical Pathology

Background:

• Pilonidal sinuses (PS) typically occur in the sacrococcygeal area, predominantly in young males.
• Extrasacrococcygeal pilonidal sinus (ESPS) represents a less common manifestation of this condition.
• Understanding ESPS ethiopathogenesis and treatment is crucial for comprehensive patient care.

Observation:

• A retrospective analysis of 949 pilonidal sinus cases identified 21 instances (2.2%) of ESPS between 2006 and 2011.
• ESPS affected diverse anatomical locations including the breast, scalp, sternum, abdominal wall, neck, groin, and axilla.
• Notably, pilonidal sinus of the breast and groin have not been previously documented in existing literature.

Findings:

• The study identified ESPS in the breast (n=1), scalp (n=2), sternum (n=2), abdominal wall (n=5), neck (n=2), groin (n=4), and axilla (n=5).
• Abdominal wall lesions, while rare, were observed with a frequency comparable to other extrasacrococcygeal sites.
• Histological examination revealed that pilonidal sinus can mimic hidradenitis suppurativa.

Implications:

• The findings suggest that shaving the affected region may be a contributing factor in the pathogenesis of ESPS.
• The documentation of ESPS in the breast and groin broadens the known clinical spectrum of pilonidal sinus disease.
• Further research into the specific etiological factors and optimal management strategies for ESPS is warranted.