A scoping review on clinicopathological characteristics, diagnosis, and management of intermammary pilonidal sinus...

Intermammary pilonidal sinus disease (IMPSD) is a rare condition that primarily affects the young population. Due to the absence of standardized guidelines, IMPSD poses significant challenges during management.

This scoping review aims to map and characterize the existing literature on IMPSD to provide an overview of clinicopathological characteristics, risk factors, diagnosis, and management.

Studies were included if they were original articles, case reports, or case series that met the inclusion criteria published in English during 2004 to 2024.

A search was conducted using MeSH keywords "Intermammary" AND "Pilonidal sinus" in PubMed, Google Scholar, and by citation searching up to date.

The PRISMA ScR guidelines were used as a charting method. Data extraction included demographic characteristics, clinical pathological characteristics, diagnostic methods, treatment approaches, and follow-up outcomes.

Ten articles met the inclusion criteria, including 33 patients with a mean age of 18.7 years. The majority of cases were reported from Turkey, Iraq, and India. Mean body mass index was 28.74 kg/m². Significant other comorbidities included polycystic ovary syndrome in 24% of cases. Large pendulous breasts and wearing tight brassieres were noted as other risk factors. Clinical presentation commonly involved discharging sinuses and painful swellings, with a mean duration of 8 months. Complementary investigations were seldom performed as the diagnosis was mainly clinical. The main modes of treatment included resection with primary closure or resection with secondary healing.

Low prevalence and management challenges highlight the need for further research to establish standardized guidelines and the importance of formulating an individualized plan for the management of IMPSD based on a comprehensive evaluation of clinicopathological characteristics and patient wishes.