Clinical features

Typically the pilonidal sinus patient is male with thick black hair. The mean age of presentation is 21 years in men and 19 years in women (1).

The most common site for the pilonidal sinus is over the sacrum in the gluteal cleft. Other sites include the hands, axillae and the umbilicus.

The patient complains of recurrent episodes of pain or sepsis. There are often periods of several months between episodes. As the size of the sinus increases the frequency of painful episodes also increases.

On examination a pit is seen in the midline of the sinus. One sinus may have several pits. The hairs are visible pointing into the sinus. Pressure on the sinus may exude pus or blood from the pit(s).

Reference

1. Notaro J.R. Management of recurrent pilonidal disease. Semin. Colon Rectal Surg. 2003;14(4):173–185.
2. Gil LA, Deans KJ, Minneci PC. Management of pilonidal disease: a review. JAMA Surg. 2023 Aug 1;158(8):875-83.