An atypical localization of pilonidal sinus: The scalp

Abstract

Pilonidal sinus is a disease generally localized in the sacrococcygeal area that is especially seen in men. Pilonidal sinus cases have been reported to occur, except for this area, in the umbilicus, forehead, clitoris, interdigital area, penis, abdominal wall, neck, axilla, chin and nose, and more rarely in the scalp. A 27-year-old female patient, who had no history of previous trauma or surgical procedure in the scalp, had complaints of a painful swelling for about the last 3 years and an occasional foul-smelling discharge for the last year in her scalp. Her physical examination showed a running sinus opening and sensitivity in the occipital area. Wide excision and primary repair were performed under local anesthesia with pilonidal sinus pre-diagnosis. No signs of recurrence were observed in her 6th-month follow-up. Although pilonidal sinus in the scalp is a rare pathology, it can give way to serious cosmetic problems in patients and it should be especially noted in the differential diagnosis of scalp lesions presenting with fistula formation. A wide excision of the sinus cavity can prove to be sufficient in treatment.