What are the signs and symptoms of pilonidal disease?

Updated: Jun 11, 2018
  • Author: M Chance Spalding, DO, PhD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Although pilonidal disease may manifest as an abscess, a pilonidal sinus, a recurrent or chronic pilonidal sinus, or a perianal pilonidal sinus, the most common manifestation of pilonidal disease is a painful, fluctuant mass in the sacrococcygeal region.

Initially, 50% of patients first present with a pilonidal abscess that is cephalad to the hair follicle and sinus infection. Pain and purulent discharge from the sinus tract are present 70-80% of the time and are the two most frequently described symptoms. In the early stages preceding the development of an abscess, only a cellulitis or folliculitis is present. The abscess is formed when a folliculitis expands into the subcutaneous tissue or when a preexisting foreign body granuloma becomes infected.

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