Non-sacrococcygeal pilonidal sinus; a rare but growing disease; a systematic review

Abstract

Pilonidal sinus disease (PND) is an inflammatory condition originated from hair penetration into the epidermis. In this condition, a blind tract will be formed which is lined by granulation tissues (1).  The clinical signs are the same spectrum of signs and symptoms of inflammation including pain, hotness, erythema and tenderness, some times it present as a intermittent purulent discharge (2, 3).  Usually it appears in the sacrococcygeal region of those persons with prolong sitting like the drivers (Faruq). Several techniques have been practiced as a management strategy of PND. These includes removal of the hairs and cotton-like dirties in an outpatient clinics and excision with or without flaps.  General, regional or local anesthesia has been used int the intervention (7).  Recently, non-operative management has been increasingly discussed in the literature (salih myoclinic).  Several non-sacorcoccygeal PNDs have been reported in literature including small case series and case reports  (5- 8). This type of PNS sometime misdiagnosed as other disease (basal cell-PNS).  Clinical courses and management options of non-sacrococcygeal PND have never been agreed on by the experts. The aim of this review is to collect, analyse, present and discuss the management of PND occurring in the body other than sacrococcygeal regions.