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Pilonidal cyst

Pilonidal cysts are pockets of skin in the crease of the buttocks near the end of the tailbone (coccyx). that can become infected and filled with pus. Once infected, the technical term is pilonidal abscess. Although usually found near the tailbone, this painful condition can be found in several places, including the navel or the armpit. It develops in a cyst ( pilonidal cyst ) at the top of or next to the crease of the buttocks (overlying the sacrum ). Men are affected two to three times more often than are women, and the cysts typically affect those younger than 40. Pilonidal abscesses look like a large pimple at the bottom of the tailbone, just above the crack of the buttocks. Conditions in which it commonly occurs include obesity , body hair around the area in question, and a sedentary lifestyle .When a pilonidal cyst gets infected it forms an abscess, eventually draining pus through a sinus. Pilonidal cysts are harmless until they get infected, at which point they form an abscess that causes pain, a foul smell, and drainage. This event is more likely to occur in young Caucasian men with abundant hair in the region. It is interesting that a bony spur or spicule on the coccyx is often related to a sinus in the skin at this point. It suggests to me that these two conditions are part of a spectrum of conditions which have their origin in the way that the spine is formed in the embryo and the skin closes over it. Pilonidal cysts often cause discomfort. But the main concern is infection, which can result in a painful abscess. Treatment includes removing hair from the area and surgery to open and drain the cyst.

Causes of Pilonidal cyst

The common Causes of Pilonidal cyst :

  • Congenital pilonidal dimple
  • Skin and perineal bacteria such as Staphylococcus aureus and Bacteroides species invade the opening and cause infection.
  • Congenital dermal sinus (of which the dimple is the mildest form)
  • Neighbouring hairs or free hairs from other parts of the body collect in the pit and invade the small opening created by the distorted hair follicles.
  • Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles, which when subjected to friction and motion, are injured and disrupted so the hair pokes through the wall of the follicle into the surrounding skin setting up a foreign body reaction.

Symptoms of Pilonidal cyst

Some common Symptoms of Pilonidal cyst :

  • Swelling at the bottom of the spine.
  • If infected the draining pus may have a foul odour.
  • Redness at the bottom of the spine.
  • Fever, malaise or nausea.
  • Visible or lumpy tracts 2-5 cm long in chronic or recurrent disease.
  • Draining pus.

Treatment of Pilonidal cyst

  • Antibiotics to treat the infection.
  • Surgery to drain the abscess or remove the cyst.
  • Asymptomatic cyst or sinus tracts should be referred to a surgeon for further evaluation to remove the internalized material.
  • During this procedure, you're given a local anesthetic to numb the area before your doctor opens and drains the cyst. Afterward, your doctor packs the wound so that it can heal from the inside out.


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