Pilonidal cyst

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A pilonidal cyst (from Latin meaning 'hair nest') is a blanket term for any type of skin infection near the tailbone. These are normally quite painful, occur somewhat more often in men than in women, and normally happen in early adulthood. Although usually found near the tailbone, this painful condition can be found in several places, including the navel or the armpit. Development of the condition in a place other than the tailbone is exceedingly rare, however. It usually happens in young people, up to their thirties in age. Conditions in which it commonly occurs include obesity, body hair around the area in question, and a sedentary lifestyle. While a traumatic event is not believed to cause a pilonidal cyst, such an event has been known to inflame existing cysts.

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[edit] Diagnosis

Doctors are not sure what causes a pilonidal cyst. An old theory is that a small and harmless cyst has always been present at birth, and that for some reason, it has become irritated and formed a painful abscess. Another explanation is that it is an ingrown hair that has formed an abscess. It is very rare to find hair follicles inside the cyst—however,it is very common for drained cysts to contain hair, though this is not thought to be the sole cause of the condition. The cause is more likely to be due to repeated shearing stress by the buttocks in the natal cleft. This causes small areas of inflammation to form. The hair found in the cysts is thought to have fallen from the head or back and the barbs of the hair cause them to get trapped in the natal cleft and work their way into the abscesses.

It was discussed by Herbert Mayo in 1830. R.M. Hodges was the first to use the phrase "pilonidal cyst" to describe the condition in 1880. It is a combination of two Latin words, pilus, meaning hair and nidal, meaning nest. The condition is now referred to as pilonidal sinus disease.

The condition was widespread in United States Army during World War II. More than eighty thousand soldiers had the condition requiring hospitalization. It was termed "Jeep riders' disease," because a large portion of people who were being hospitalized for it rode in jeeps, and it was theorized that prolonged rides in the bumpy vehicles caused the condition. The most famous American sufferer of this condition is conservative talk show host Rush Limbaugh, who was not drafted during the Vietnam War because he had been classified 4-F after a physical found that he had an "inoperable pilonidal cyst."

[edit] Treatment

Treatment for a pilonidal cyst usually begins when the patient goes to the doctor because of pain. It is treated as an infection, and a doctor might prescribe antibiotics as well as hot compresses and the application of depilatory creams to the lower back and natal cleft. Often the cyst is lanced, and surgery is a method that has met with some success for curing pilonidal cysts. Surgery on a cyst in the natal cleft involves cutting out the skin and sinus in this area. Varying methods are used to either pack the wound, or suture it partially and even completely, depending on the physician's opinion on how best to treat the patient. If the wound is packed, the patient or someone close to the patient is trained on how to replace the gauze packings. They must be replaced daily for 4 to 8 weeks. The condition can recur, even after surgery. The chance of recurrence is much greater if the wound is sutured in the midline, compared to excellent results if the resultant scar is away from the midline, thus obliterating the natal cleft and therefore removing the focus of shearing stresses. Some people develop a chronic non-healing pilonidal sinus which must be treated with surgical excision

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[edit] External links

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