Pilonidal sinus is a relatively common condition effecting mainly young males but certainly females can be effected also. The typical site is over the coccyx or tailbone. Hairs from the back or buttock get pushed through the skin usually in the midline just above the buttock crease and then pushed further in by pressure. Because hairs have scales it is one way traffic – they cannot back out. The other significant issue of course is that hairs carry bacteria in with them and this sets up an infection. Once under the skin the hairs are then pushed through the subcutaneous tissues and they can travel in any direction and for quite some distance. Whilst most pilonidal sinuses have a solitary hole in the skin there can be multiple holes resulting in a veritable rabbit warren of subcutaneous tracks and chronic abscesses opening and discharging onto the surface.
Most patients give a chronic history of the condition but it can present acutely in the form of an abscess.
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