Surgical View of Morphological and Pathogenetic Identity of Pilonidal Cysts and Acne Inversa

Abstract

Pilonidal cyst of the sacrococcygeal region is an acquired disease with the prevalence of up to 5% in the population. The overwhelming majority of patients, up to 75-80%, are males. A great number of more or less invasive methods of surgical treatment of this disease have been developed, but the results of treatment are often not satisfactory. A significant frequency of relapses of the disease, delayed healing of postoperative wounds are common. Considering the etiology and pathogenesis of this disease, a connection is visible between other pathologies: acne inversa, Hoffman's folliculitis, acne conglobata. These diseases are united by the syndrome of follicular occlusion, a condition when a lack of cytokeratin C17 leads to fragility of the sebaceous gland duct wall and inflammation of the skin tissues surrounding the hair follicle and sebaceous gland. Dermatologists successfully use retinoids, for example isotretinoin, which effectively affect the sebaceous glands, normalizing their activity and size. An integrated approach to the treatment of pilonidal cysts, an effective combination of surgical methods with a drug effect on the sebaceous glands of the skin will more efficiently solve the problem of treatment efficacy, and reduce the recurrence rate.

A Pinpoint Orifice on the Glans Penis of a Young Man

“…1,2 However, more current reports suggest that these lesions may be localized forms of hidradenitis suppurativa. [3][4][5] Pilonidal sinuses in unusual locations have been reported, including the scalp, neck, abdomen, groin, axilla, and even amputation stumps; these locations correlate with the classic sites of hidradenitis suppurativa. However, penile involve-ment is considered rare.…”

“…Some authors propose that local trauma and friction produce subcutaneous trapping of hair, leading to the formation of a cyst and then a sinus to drain the suppuration . However, more current reports suggest that these lesions may be localized forms of hidradenitis suppurativa . Pilonidal sinuses in unusual locations have been reported, including the scalp, neck, abdomen, groin, axilla, and even amputation stumps; these locations correlate with the classic sites of hidradenitis suppurativa.…”