Intermammary pilonidal sinus disease in a 13-year-old girl

Abstract

Pilonidal sinus disease (PSD) is a common acquired inflammatory condition of the skin and subcutaneous tissues that commonly affects the intergluteal cleft. In rare occurrences, PSD can occur outside the sacrococcygeal region. Here we detail a case of intermammary PSD in a 13-year-old female who presented with recurrent intermammary cysts and underwent successful wide local excision with primary closure. Intermammary PSD is a rare condition associated with young, obese females with large breasts kept in tight brassieres. A high index of suspicion is required as intermammary PSD is a clinical diagnosis. Wide local excision of the entire sinus tract with primary closure is the recommended treatment to decrease recurrence and optimize cosmetic outcome. Our case report adds to the limited pediatric literature for this diagnosis and highlights the rare presentation and management of intermammary PSD. • Intermammary pilonidal sinus disease is a rare presentation of a common disease. • Associated with young, obese females with large breasts who wear tight brassieres. • Wide local excision with primary closure is recommended.