Pilonidal disease Signs and symptoms

Pilonidal disease
Signs and symptoms
Although pilonidal disease may manifest as an abscess, a pilonidal sinus, a chronic or recurrent sinus or perianal pilonidal sinus, the most common manifestation of disease is the appearance of a fluctuating mass, painful sacrococcigeana region. Initially 50% of patients will present a pilonidal abscess in the direction of hair growth and sinus infection.
Pain and removal of pus from the sinus tract is encountered in 70-80% of cases and are the most common symptoms. In the initial stages before the development of an abscess or cellulitis is present only folliculitis. Abscess is formed when a follicle extending into the subcutaneous tissue, when a foreign body granuloma becomes infected. Subcutaneous sinus cavity and side to side are lined by granular tissue and only a primitive path is epithelizant sinus buttocks.
Pilonidal sinus diagnosis can be made by identifying epithelizant follicular opening is palpable as an area of induration beneath the skin deep sacral region. These tracks usually have a centripetal direction. When trajectories are oriented caudally perianal sepsis may be present.
Differentiation between pilonidal disease and anal fistula hidroadenita can be difficult. The differential diagnosis of intra-and Furuncles, syphilitic granuloma, tuberculous granuloma and sacral osteomyelitis with draining sinus.
Recurrent pilonidal disease is most often encountered after incision and drainage of pilonidal abscess. In this case pilonidal sinus has been excised and is still present after the abscess cavity heals, precipitating recurrence. After surgical excision, hair follicles were removed and no longer triggering factors appellant pilonidal sinus. It is considered that the basis of an unhealed surgical wound is filled with granular tissue, hair and skin debris, representing a new beginning for the reaction of foreign body causing chronic disease. This theory with predisposing anatomy intergluteala hair that attracts pilonidal sinus cavity or surgical wound is thought to precipitate extensive recurrent and chronic disease.
Sinus is a rare form of endoanal pilonidal disease that directly affects or is circumferential perianal skin around the anus, involving the anal skin. Three cases have been described perianal pilonidal disease. First, pilonidal sinus caudally down cause the formation of cracks or communication with the anal fistula. Second, the hair may come in which is being wound healing of anal fistulas treated surgically. Third, the hair can be drawn, producing a normal anodermul penetrating foreign body reaction similar to that observed in the region sacrococcigiana.