Pilonidal cyst disease

Abstract

Pilonidal sinus disease is a chronic subcutaneous inflammation in the upper part of the gluteal cleft. First described by Mayo in 1833, this nest of hairs was aptly named by Hodges in 1880, who first used the term pilonidal sinus (Latin pilus hair, nidus nest). For some time, the midline nature and presence of hair in the wound misled physicians, who hypothesized that pilonidal disease was an infection of a congenital cyst or pit of the sacrococcygeal area. However, over the past 60 years, it has been argued convincingly that this disease is acquired and the cystic nature of the abscess cavity is likely due to chronic infection and inflammation. This acquired etiology is supported by: (1) the occurrence of similar lesions in other sites of the body, occasionally associated with minor trauma (interdigital spaces of hair stylists and barbers), (2) the increased incidence associated with a sedentary occupation or lifestyle (jeep-drivers disease of World War II), and (3) the absence of typical histological features in the pilonidal cyst to suggest a congenital origin (absence of hair follicles and skin appendages despite the presence of hairs in the cyst wall, lack of epithelium of the internal cyst wall). © 2011 Springer Science+Business Media, LLC.