Pilonidal sinus of hand; presentation and management: A systematic review of literature

Abstract

Pilonidal sinus disease may occur in the hand, the presentation and management of which is not well studied, the aim of this review is to highlight the presentation and management of pilonidal sinus disease of hand. Google scholar engine, Cochrane library, PubMed and Web of Science have been searched for the keywords. After exclusion of the unrelated papers, the search found 26 articles. The cases were presented and discussed collectively as the number of patients included in each study was few. The search found 31 patients complaining from pilonidal sinus of interdigital areas. Twenty-six (83.9%) cases were male, 5 (16.1%) cases were females, 23 (74.2%) patients were barbers; other 8 (25.8%) patients were animal groomers. Right hand was affected in 22 (67.7%) cases and in left hand in 10(32.3%) cases. Chronic painful discharging sinus was the most common presenting symptom occurring in 16 (51.6%) patients. Abscess and cystic-like lesions were found in 10 (32.3%) patients. Excision and daily dressing was done for 28 (90.3%) cases, incision and drainage were performed in 2 (6.4%) cases. Recurrence occurred in 5(16.1%) cases. Hand pilonidal sinus is an occupational disease solely affects those individuals who work with hair including barbers and hairy animal groomers. The main presenting symptoms are similar to the pilonidal sinus disease of other areas. Surgical excision with daily dressing is the main line of therapy.