Unusual sites and presentations of pilonidal sinus disease

Abstract

Pilonidal sinus usually develops in the sacrococcygeal area or other hair-bearing areas. However, it can present at some other sites with varied presentations and can mimic like other infective pathologies which are more common in that area. It has also been described as an occupational hazard in barbers, especially when presented interdigitally. Occupational pilonidal sinuses tend to occur even in non-hair-bearing areas where there is no presence of individual?s own hair. Pilonidal sinus occurs in many areas of the body such as web of fingers, penis shaft, axilla, intermammary area, groin, nose, neck following trauma during shaving, clitoris, sternum, suprapubic area, occiput, prepuce, chin, periungual region, breast, face or navel. Sporadic incidences of implantation of pilonidal sinus have been reported. The disease is mostly observed in hairdressers, but it has also been reported sporadically in other professions, as male sheep shearer, dog groomer, slaughter men or milker of cows. Short customers? hairs that penetrate the supple interdigital skin of the hands produce barber?s disease. Though there are only a few reports about these peculiar sinuses in the available literature, they should be suspected in any chronically discharging, non-healing sinus or wound. A clinical suspicion of malignant transformation or affection with tuberculosis in the endemic area should also be kept in mind to avoid any delay in the treatment and the outcome of the disease.