Pilonidal sinus of the penis

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

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 disease of the penis: A case report and review of the literature

Pilonidal sinus disease (PSD) is an acquired pathological condition more commonly seen in the natal cleft of the sacrococcygeal area, although its presentation is not limited to the natal cleft and it can present in other regions of the body such as the breast, umbilicus, scalp and penis. We present the case of a 28-year-old gentleman who presented to his local Urology outpatient clinic with an unusual penile lesion that was later identified as a pilonidal sinus. This was treated with radical circumcision and penile reconstruction with a good functional outcome. For surgeons unaccustomed to PSD presenting on the penis, there is a potential for delay in diagnosis and sub-optimal management of this rare lesion.

Pilonidal sinus cyst of the penis: a rare manifestation of a common disease

Pilonidal sinus is a chronic inflammatory condition owing to the subcutaneous trapping of hair. Most commonly it is found in the sacrococcygeal region (natal cleft) but rarely it is found on the penis with very few cases reported in the literature worldwide. We are reporting a case of a pilonidal sinus growing on the distal penile shaft with the sinus opening to the mucosal layer of the foreskin, in a young and fit patient. The cyst was removed with a circumcision and found to contain hair. This was confirmed by histology as a pilonidal sinus cyst.

Pilonidal sinus of the penis

Pilonidal sinus is a well recognised chronic inflammatory condition which commonly affects the natal cleft and finger web space. Pilonidal sinus of the penis is a rare clinical entity; few cases have been reported previously. The treatment strategy is almost the same as treating any pilonidal sinus and involves total excision of the sinus. Our diagnosis was established on the histopathological findings rather than a clinical-based diagnosis, Follow-up is advisable since the recurrence rate is high. Our case report is one of few cases reported on pilonidal sinus all over the world. Our patient had total excision of the sinus with complete recovery.

Candida sepsis originating from bulbar abscess of the penis

We describe a patient with a very unusual penile abscess. Antibiotic treatment for Clostridium sordellii and Candida albicans infection and drainage of pus was curative. We propose that the penile abscess may have been an unusual manifestation of a rectal fistula.