Pilonidal abscess - Cellulitis
The spectrum of pilonidal disease also includes asymptomatic cysts and sinuses. Initially, pilonidal disease was believed to be congenital in nature. The most popular theory nowadays, however, regarding the mechanism of disease is that of excessive repetitive trauma to the sacrococcygeal region, illustrated by the prevalence of this problem among Jeep drivers in World War II (so called "Jeep disease").
Risk factors for pilonidal disease include male sex, hirsutism, obesity, occupations requiring extended periods of sitting, and presence of a deep natal cleft. Pilonidal abscesses are more common in adolescence and young adulthood. Systemic signs and symptoms are rare.
Pilonidal abscesses should be differentiated from cellulitis based on the finding of a fluctuant mass in the presacral area.
L05.01 – Pilonidal cyst with abscess
- Cellulitis or erysipelas
- Fournier gangrene
- Perianal abscess arising from the posterior midline crypt
- Perirectal abscess
- Hidradenitis suppurativa
- Sacral osteomyelitis
- Anal fistula
- Coccygeal sinus
- Pyoderma gangrenosum
- Ecthyma gangrenosum
- Presacral sinus or dimple
- Dermal sinus tract (dermal sinus is usually found above the gluteal cleft and the pilonidal disorder within the gluteal cleft)
- Congenital anomaly (ie, spina bifida occulta)