Intermammary pilonidal sinus in women. Diagnosis and treatment

Globally, the term pilonidal sinus disease (PSD) is most frequently used for lesions in the sacrococcygeal region. The inter-mammary sulcus is a rare location for pilonidal sinus abscesses. Our study examined the causes of inter-mammary PSD (IMPSD), which is rarely seen in the literature and our treatment approach.

We retrospectively analyzed patients referred to our hospital's general surgery clinic between 2012 and 2018. Twelve patients were operated on for IMPSD during these six years. An excision, including all sinus openings, was planned, and a D-shaped incision was performed. Sinus openings and tracts underlying the skin were excised in toto. Subcutaneous flaps were created to shift the incision from the midline plane to reduce the recurrence rate. The minimum duration for the follow-up was 24 months. Eight patients were suffering from polycystic ovary syndrome. Progesterone and testosterone levels of the patients were normal. Prior studies evaluating PSD and hormone levels of female patients showed no correlation.

IMPSD is a disease that should be kept in mind if induration and abscess in the inter-mammary region are present. The risk of recurrence is high if no proper excision is planned. A D-shaped incision including all sinus tract openings and a midline shift prevented our series' possible recurrences. HIPPOKRATIA 2020, 24(2): 84-87.