Rare Location for Pilonidal Sinus: the Nasal Dorsum

Area of Science:

• Dermatology
• Plastic Surgery
• Pathology

Background:

• Pilonidal sinus is a chronic inflammatory condition typically affecting the sacrococcygeal region.
• It results from hair penetration into the skin, leading to sinus tract formation.
• Atypical presentations can mimic other conditions, complicating diagnosis.

Observation:

• A 20-year-old male presented with nasal dorsum swelling and a hair-containing fistula.
• Physical examination confirmed a lesion with characteristics suggestive of a sinus tract.
• The lesion's location on the nasal dorsum is highly unusual.

Findings:

• Surgical excision was performed using an open rhinoplasty approach.
• Histopathological examination confirmed the diagnosis of pilonidal sinus.
• This confirms pilonidal sinus can occur in rare, atypical locations.

Implications:

• The case highlights the importance of considering pilonidal sinus in hair-containing nasal lesions, beyond common differentials like dermoid cysts.
• Accurate histopathological examination is crucial for correct diagnosis.
• Prompt and correct diagnosis facilitates effective management and treatment of symptomatic pilonidal sinus.