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Pilonidal abscess - Cellulitis DDx
See also in: Skin,Anogenital
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Pilonidal abscess - Cellulitis DDx

See also in: Skin,Anogenital
Print Images (3)
Contributors: Tara Mahar MD, Art Papier MD
Other Resources UpToDate PubMed

Synopsis

A pilonidal abscess results from a disruption of the epithelium in the gluteal fold overlying the coccyx, with formation of a small pit. Squamous epithelium gradually lines this cavity, which then plugs with hair or keratin, thus preventing drainage and promoting abscess formation. Diagnosis is made by establishing the presence of a painful, fluctuant area in the presacral skin. These abscesses contain a combination of skin and perineal flora.

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.

Codes

ICD10CM:
L05.01 – Pilonidal cyst with abscess

SNOMEDCT:
432863009 – Pilonidal disease

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Last Updated: 01/12/2017
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Pilonidal abscess - Cellulitis DDx
See also in: Skin,Anogenital
Print 3 Images
View all Images (3)
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Pilonidal abscess : Erythema, Perianal-anus, Skin warm to touch, Painful skin lesion
Clinical image of Pilonidal abscess
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