The Multifaceted Pilonidal Disease: A Review of this Dermatological Machiavellian!

Chronic Skin lesions are characterized by signs of inflammation the nature and duration of these illness affects the disease outcome. Pilonidal Disease (PD) is a chronic dermatological disorder Characterized by formation of regional follicles abscesses that progress to fistulas & Scars over the period of years. The Clinically myriad features of Pilonidal Disease (PD) presentation depends upon the site and the anatomical location of the disease process. The Clinical features of Axillary pilonidal disease is different from the Mammary pilonidal disease. The spectral clinical presentation for the groin, genitals & Umbilical pilonidal disease is even more diverse. Hence the patients end up to different specialities like medicine, dermatology, gynaecology, surgery, cosmetic surgery even under infection control mislabelled as tuberculosis and actinomycosis. The disease takes a toll on subjects with chronic Pain & foul-smelling discharge as they continue to live life bondaged to dressings. Over time the individual develops a negative impact on their psyche socially it affects their relationships even takes a toll on their caregivers. The differential diagnosis associated with Pilonidal disease is momentous this dermatological condition has a multifaceted presentation all depending on the stage & the anatomical zone of presentation. It is easily passed off initially as an epidermoid cyst or an abscess, furuncle, carbuncles,Staphylococcal skin infections as pyoderma, Bartholin cysts Ano Cutaneous Crohn disease even as Hidradenitis suppurativa (HS). The controversies that were associated with its origins may have been resolved but optimal treatment modalities that reduce recurrences continue to be debatable.