Although the condition of pilonidal sinus may involve the clefts between the fingers, particularly in barbers, the problem usually occurs just above the cleft of the buttocks.
Once thought to be mainly due to a congenital defect of a blind track or sinus in the skin, it is now mostly accepted that the condition is acquired and results from hairs pushing their way into the skin in this area. The hairs may come from the head, the back or the buttocks.
It is commoner in men and particularly dark, hairy men.
A small infection develops like a boil just above the buttocks. Antibiotics may control the infection but it usually recurs and pockets of pus may persist.
Small abscesses may be incised and drained during the acute infection.
Most cases eventually require operation, usually laying open the tracks and pockets and clearing them of pus and retained hairs. If the area is large, a skin graft may be necessary.
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