Does Pilonidal Sinus Locate In The Scalp?

Abstract

Pilonidal sinus disease has been described as a hair dressers’ or (barbers’) disease because of short hairs that penetrate the interdigital spaces of the hand. Pilonidal sinus disease is common around the sacrococcygeal region but rarely seen in the anal canal, umbilicus, chest wall, ear, or on the scalp.Our case involves a 21-year-old man who was doing his military service. He complained of a mass which he had had for several years around the left occipital region of the scalp, the patient’s medical history seemed uneventful. We totally excised the lesion and sutured. After the operation, histopathology confirmed our diagnosis as pilonidal sinus of the scalp. After a three-month follow-up, the patient had made a complete recovery.Pilonidal sinus disease involves a hair-containing sinus first described by Herbert Mayo in 1833 [1]. In 1880, Hodge suggested the term “pilonidal”[2] from the Latin “pilus” for hair and “nidus” meaning nest, and later Karydakis [3,4] defined the pathogenesis of this disease. After a long debate the disease is no longer considered a congenital abnormality even though 50-70% of cases have hair shafts in the lesion. Pilonidal sinus disease has been described as a hair dressers’ or (barbers’) disease because of short hairs that penetrate the interdigital spaces of the hand [5,6,7]. The mechanism for the formation of sinuses by hairs was postulated by Hodges in 1880 in an article on postnasal pilonidal sinus [2]. The first case of a sinus in a hairdresser was described by Templeton in 1942 [7]. Pilonidal sinus disease is common around the sacrococcygeal region [8] but rarely seen in the anal canal [9], umbilicus [10], chest wall [11], ear [12], or on the scalp [13]. As near as we can determine, only a few cases appear in the existing literature. We are reporting here on an unusual case of pilonidal sinus of the scalp with no apparent reason.