Pilonidal sinus of the cheek: an extremely rare clinical entity—case report and brief review of the literature

Abstract

Background Pilonidal sinus is commonly seen at the sacrococcygeal region and few other sites, usually located at the midline, at areas where hairs collect or near protuberances or some adjacent rubbing surfaces. Its presence elsewhere is uncommon. We share an interesting case of a recurrent discharging sinus from the cheek bulge of a male which turned out to be a pilonidal sinus containing tuft of hairs on exploration and wide excision. Case presentation A 37 years old hirsute male presents to us with a non-healing discharging sinus at the bulge of the cheek. Exploration after a course of antibiotics showed 2 subcutaneous cavities with tuft of hairs. The area was excised along with a margin, thorough irrigation and curettage was done and the wound was closed primarily; a Z-plasty was incorporated in the central part to break the resultant suture line. Histopathological examination was done to confirm the diagnosis and rule out an off-midline dermoid cyst or an underlying/coexisting malignancy. Post-operative course was uneventful. The patient has been recurrence free for 1.5 years and is satisfied with the nature of the scar. Conclusions Pilonidal sinus of the cheek bulge is an extremely rare entity. Complete excision and clinical suspicion are important for cure of this nagging ailment, especially at unexpected areas.

Pilonidal sinus of breast, a case report with literature review

“…The four major reasons for the formation of PNS are hair penetration to the skin, skin folding in the natal cleft, hormonal effect, and continuous pressure on atypical areas [ 7 ]. Abscess and chronic persistent secretion are regarded as the major clinical manifestations of the disease [ 2 ]. The current case was a 31-year-old female with two painful lumps at her right breast with a continuous serosanguinous foul odored discharge.…”

“…It is mostly asymptomatic, and the appearance of a small-sized ditch on the skin surface can be the only sign of its occurrence. The main clinical manifestations include abscess formation or chronic persistent secretion [ 2 ]. PNS mainly affects the intergluteal cleft or sacrococcygeal regions but rarely can occur in the other parts of the body [ 3 ].…”

Facial Pilonidal Sinus in a Middle-Aged Woman

“…It typically presents as recurrent chronic inflammation and involves the sacrococcygeal region in men aged 15 to 30 years. 1,2 To date, only 12 cases of facial PNS have been reported in English literature, including 11 males and 1 female. 1–4 We describe a case of asymptomatic PNS on the forehead in a middle-aged woman.…”

“…1,2 To date, only 12 cases of facial PNS have been reported in English literature, including 11 males and 1 female. 1–4 We describe a case of asymptomatic PNS on the forehead in a middle-aged woman.…”

“…Pilonidal sinus manifests often as an asymptomatic hair-containing cyst with a small pit on the lesional surface and occasionally as a recurrent discharging sinus or an abscess. 1 Pilonidal sinus can seldom occur in atypical locations such as axilla, inguinal region, umbilicus, suprapubic region, clitoris, circumcision skin, scalp, penis, and face. 1,2 Of 12 reported cases of facial PNS, the nose (5 cases) is most commonly affected, followed by the cheek (2), chin (1), mandible (1), buccal area (1), forehead (1), and preauricular area (1).…”