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Pilonidal disease is defined as a chronic skin problem, which is found most commonly in the sacrococcygeal region. It is in the form of a cleft and is present between the buttocks just below the base of the spine.
In this case, one or more sinus tract is present that is they are the cavities with a narrow opening on the surface and are known as pilonidal sinus. In many of the cases, the cavity many of the cases, the cavity is field with nests of hair, hence the name pilonidal is given, as the word pilus means hair and nidal means nest.
A non-inflamed lump is known as a pilonidal cyst. It has been known that if the sinus becomes infected thena pilonidal abscess may form.
Causes of Pilonidal Disease
The exact cause of Pilonidal disease is not known of it there are few reasons of it, which are as follow: -
Various types of skin and perineal bacteria such as staphylococcus aureus and bactericides species commonly invoke the opening and causes infection. Moreover, some people are born with small holes or pits near the base of the spine.
These pits are infact enlarged hair follicles, which are when subjected to friction and motion, gets injured and disrupted and therefore, the pokes through the wall of the follicle into the surrounding skin set up a foreign body reaction. There are also neighboring hairs or free hairs from other parts of the body which collect in the pit and invade the small opening created by the distorted hair follicles.
Pilonidal disease is seen equally in both men and women. Mainly 20-40 years of age of people are affected. Other factors that increase the risk of pilonidal disease are like obesity, person with coarse, curly or crinkly hair, poor hygienic conditions.
Prolonged sitting or buttock friction which causes increased sweating may also lead to the development of Pilonidal disease. Family predisposition also plays a major role in the causation of Pilonidal disease. If repeated local injury occurs in an individual, then he is at major risk for Pilonidal disease.
Symptoms of Pilonidal Disease
Signs and symptoms of Pilonidal disease are generally variable. They may vary from a small dimple or painless pit at the base of the spine to a large painful mass or abscess.
Many patients visit doctor and complain of progressive tenderness, chiefly after prolonged periods of sitting such as during a long drive. Often the infected area drains fluid that may be clear, cloudy or body. Due to infection the area becomes red, tender and drainage of pus occurs which have a foul odour. The infection may also lead to fever, malaise or nausea.
Visible or lumpy tracts, which are 2-5 cm long, are seen in chronic or recurrent disease. The chronic disease causes episode of swelling, pain and drainage. Surgery is usually required to resolve this condition.
Treatment of Pilonidal Disease
A pilonidal disease, which does not cause any problem, requires no treatment. The patient is just advised to keep the area clean and free of hair by shaving or using a hair removal agent every 2-3 weeks. The cyst may resolve itself.
But if it becomes inflamed and develops acute pilonidal abscess then it will need to be incised and its contents are drained out to reduce inflammation and pain.
In certain cases, the abscess cavity may be cut out completely to remove hair nests and skin debris and hence it reduces the recurrence rate of the disease. While the complex and recurrent disease is treated surgically
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