From the Research
No, a pilonidal cyst does not present as a cyst on a stem base. A pilonidal cyst typically forms in the sacrococcygeal region (the cleft between the buttocks near the tailbone) and appears as a dimple or pit in the skin that may contain hair. These cysts develop when loose hair penetrates the skin, causing inflammation and infection. They do not grow on stems or stalks like some other skin lesions might. Pilonidal cysts usually present with symptoms such as pain, swelling, redness, and sometimes drainage of pus or blood if infected. Treatment typically involves surgical drainage for acute infections, followed by complete excision of the cyst and sinus tract for definitive management, as supported by studies such as 1. Antibiotics may be prescribed if there is surrounding cellulitis, with common choices including broad-spectrum coverage such as amoxicillin-clavulanate or trimethoprim-sulfamethoxazole. Good hygiene, regular hair removal in the area, and avoiding prolonged sitting can help prevent recurrence after treatment. Some studies have reported rare locations of pilonidal cysts, such as on the vault 2 or involving the clitoris 3, but these are exceptions rather than the typical presentation. The most recent and highest quality study, 1, provides dermoscopic features of pilonidal cyst disease, which can aid in diagnosis, but does not describe the cysts as being on a stem base. In clinical practice, it is essential to consider the typical presentation and symptoms of pilonidal cysts to provide accurate diagnosis and effective treatment, prioritizing morbidity, mortality, and quality of life as outcomes. Key points to consider in the management of pilonidal cysts include:
- Typical location in the sacrococcygeal region
- Presentation as a dimple or pit in the skin with possible hair content
- Symptoms such as pain, swelling, redness, and drainage of pus or blood if infected
- Treatment involving surgical drainage and excision, with possible antibiotic use for surrounding cellulitis
- Prevention of recurrence through good hygiene, hair removal, and avoiding prolonged sitting.