II. Epidemiology

  1. Infection occurs most often in males, age 16 to 30

III. Predisposing factors

  1. Men
  2. Dark-skin
  3. Hirsutism

IV. Pathophysiology

  1. Pit forms at skin disruption in gluteal fold
  2. Pit plugs with hair and keratin
  3. Abscess forms when drainage of pit is blocked

V. Symptoms

  1. Pain in gluteal fold
  2. No systemic symptoms

VI. Signs

  1. Midline tender swelling in gluteal fold over Coccyx

VII. Management

  1. Incision and Drainage under Local Anesthesia
    1. Do not make incision in midline (risk of non-healing)
    2. Make small incision lateral to midline
  2. Consider surgical referral for cyst and sinus excision
    1. See recurrence rates below

VIII. Complications

  1. Recurrent infections: 10 to 90%

IX. References

  1. Marx (2002) Rosen's Emergency Medicine, p. 1952

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Ontology: Pilonidal Cyst (C0031925)

Definition (MSH) A hair-containing cyst or sinus, occurring chiefly in the coccygeal region.
Concepts Anatomical Abnormality (T190)
MSH D010864
ICD9 685
ICD10 L05 , L05.91, L05.92
SnomedCT 47639008, 200711002, 302223003, 156320006, 267837002, 302224009, 200716007
English Cysts, Pilonidal, Pilonidal Cysts, Pilonidal Sinus, Cyst, Pilonidal, PILONIDAL CYST, Sinus, Pilonidal, Pilonidal sinus/cyst NOS, PILONIDAL SINUS, Pilonidal sinus/cyst, pilonidal cyst, pilonidal cyst (diagnosis), Pilonidal cyst NOS, Pilonidal cyst and sinus, Pilonidal Sinus [Disease/Finding], pilonidal cyst sinus, Cyst;pilonidal, Fistula;pilonidal, pilonidal sinus cyst, pilonidal sinus/cyst (non-specific), pilonidal cysts, sinus pilonidal, coccygeal sinus, cyst pilonidal, pilonidal sinus, pilonidal sinus (diagnosis), Pilonidal sinus/cyst (disorder), Pilonidal sinus (finding), Sinus - pilonidal, Cyst - pilonidal (finding), Pilonidal sinus/cyst NOS (disorder), Coccygeal sinus, Pilonidal sinus, Coccygeal fistula, Piliferous cyst, Pilonidal fistula, Cyst - pilonidal, Cyst - pilonidal (disorder), Pilonidal cyst, coccyx; sinus, cyst; pilonidal, fistula; pilonidal, pilonidal; cyst, pilonidal; fistula, pilonidal; sinus, sinus; coccygeal, sinus; pilonidal, Pilonidal cyst, NOS, Pilonidal Cyst, pilonidal fistula, Sinus;pilondial
French KYSTE PILONIDAL, Kyste pilonidal, Sinus pilonidal
Spanish QUISTE PILONIDAL, Seno pilonidal, quiste/fístula pilonidal, SAI, quiste/fístula pilonidal, SAI (trastorno), fístula coccígea, fístula pilonidal, quiste pilonidal (trastorno), quiste pilonidal, quiste pilífero, seno coccígeo, seno pilonidal, Quiste pilonidal, Quiste Pilonidal, Seno Pilonidal
German PILONIDALZYSTE, Sinus pilonidalis, Pilonidalsinus, Pilonidalzyste
Swedish Pilonidalcysta
Japanese モウソウノウホウ, モウソウドウ, ピロニダールサイヌス, 毛巣洞, 毛巣嚢胞, 毛巣嚢腫, 毛巣瘻
Czech pilonidální sinus, pilonidální cysta, Pilonidální cysta, Pilonidální dutina
Finnish Pilonidaalisinus
Russian EKTODERMAL'NYI KRESTTSOVO-KOPCHIKOVYI SINUS, PILONIDAL'NAIA KISTA, PILONIDAL'NYI SINUS, EPITELIAL'NYI KOPCHIKOVYI KHOD, ПИЛОНИДАЛЬНАЯ КИСТА, ПИЛОНИДАЛЬНЫЙ СИНУС, ЭКТОДЕРМАЛЬНЫЙ КРЕСТЦОВО-КОПЧИКОВЫЙ СИНУС, ЭПИТЕЛИАЛЬНЫЙ КОПЧИКОВЫЙ ХОД
Portuguese QUISTO PILONIDAL, Sinus pilonidal, Quisto pilonidal, Cisto Pilonidal, Seio Pilonidal
Italian Cisti pilonidale, Seno pilonidale
Dutch pilonidale sinus, coccygeus; sinus, cyste; pilonidaal, fistel; pilonidaal, pilonidaal; cyste, pilonidaal; fistel, pilonidalis; sinus, sinus; coccygeus, sinus; pilonidalis, pilonidaliscyste, Pilonidaal cyste, Sinus pilonidalis
Korean 모소낭
Polish Torbiel pilonidalna, Torbiel zawierająca włosy, Torbiel włosowa, Zatoka włosowa
Hungarian pilonidalis cysta, Pilonidalis sinus
Norwegian Sakralcyster, Tvillingcyster, Pilonidal sinus

Ontology: Pilonidal sinus with abscess (C0342988)

Concepts Disease or Syndrome (T047)
ICD10 L05.02
SnomedCT 156321005, 200714005
English pilonidal sinus with abscess (diagnosis), Pilonidal sinus with abscess, Pilonidal sinus with abscess (disorder), pilonidal; sinus, with abscess, sinus; pilonidal, with abscess
Dutch pilonidalis; sinus, met abces, sinus; pilonidalis, met abces
Spanish seno pilonidal con absceso (trastorno), seno pilonidal con absceso