<p>Pilonidal sinus is widely associated with disease involving the gluteal cleft. Derived from the Latin word (Pilus=hair; nidus=nest), it was first described by Herbert Mayo in 1833. The pathognomonic finding of the pilonidal sinus is the presence of loose hairs in the sinus tract or cavity. We report a case of a fit middle age policeman who developed an unusual chronic discharging sinus over the tip of the nose. A computed tomography (CT) sinogram showed a localized blind subcutaneous tract over the nose. The course of management is discussed with reference to other reported works of literature. The patient was diagnosed to have a subcutaneous sinus over the tip of the nose with the aid of CT sinogram. Surgery was performed to excised the sinus tract through external rhinoplasty approached. Histopathological examination confirmed a sinus tract lined by keratinized stratified squamous epithelium with a tuft of hair. Patient was follow up for another year with no evidence of recurrence.</p>

Kimura disease is an idiopathic chronic inflammatory disorder involving the subcutaneous tissue. It favors the head and neck region, although presentation over atypical sites has been reported. This disease occurs spontaneously, has a characteristic indolent growth pattern but has a high tendency to recur locally after treatment. Due to its benign nature, there is still no clear consensus on the optimal management of this rare disorder. Various treatment options are available which include systemic steroids, antihistamines, immunosuppressant, chemotherapy, radiotherapy, and surgical excision. Presently, the disease remains a therapeutic enigma as the pathogenesis is still a mystery and its tendency to recur following treatment proves to be discouraging. Herein we report a rare case of Kimura disease involving the supra-auricular region who underwent surgical excision.