Follicular occlusion syndrome in the practice of a coloproctologist

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Abstract

BACKGROUND: Pilonidal disease is the 4th most common disease among inpatient coloproctological patients and surgery remains the “gold standard” of its treatment. However, patients with pilonidal disease often have combined conditions with other follicular occlusion diseases which are most often encountered by dermatologists in their practice. In most cases it is difficult to treat follicular occlusion syndrome with pilonidal disease within one specialty. We demonstrate the complexity of follicular occlusion diseases diagnostics in combination with pilonidal disease, systemize the diagnostic protocol for patient management and present the treatment strategy for coloproctologists.

CLINICAL CASE DESCRIPTION: There was one case of patient with pilonidal disease combined with other conditions of follicular occlusion syndrome noted in the clinic of coloproctology and minimally invasive surgery. Surgery was the first step. There were no complications in the early postoperative period. After hospital discharge, the patient was consulted by a dermatologist, and local and systemic conservative therapy was prescribed for concomitant diseases, which resulted in a significant improvement. There have been no recent reports of recurrence.

CONCLUSION: The treatment of follicular occlusion syndrome with pilonidal disease requires a multidisciplinary approach. At the same time the optimal treatment for pilonidal disease is radical excision of all altered tissues. In cases of such diseases as hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp treatment should be comprehensive and begin with a dermatologist consultation.

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About the authors

Darya D. Shlyk

Sechenov First Moscow State Medical University (Sechenov University)

Email: shlikdarya@gmail.com
ORCID iD: 0000-0002-9232-6520
SPIN-code: 4948-3550

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, Moscow

Yulia A. Ilyukhina

Medical center «On clinic»

Email: iluhinaulia@gmail.com
ORCID iD: 0000-0002-3963-6407

coloproctologist

Russian Federation, Moscow

Anna S. Pirogova

Sechenov First Moscow State Medical University (Sechenov University)

Email: annese@mail.ru
ORCID iD: 0000-0002-2246-1321
SPIN-code: 1419-2147

graduate student

Russian Federation, Moscow

Yury E. Kitsenko

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: kitsenko@kkmx.ru
ORCID iD: 0000-0002-4415-6141
SPIN-code: 4673-1926

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, 2/4 B, Pirogovskaja street, 119991, Moscow

Inna A. Tulina

Sechenov First Moscow State Medical University (Sechenov University)

Email: tulina@kkmx.ru
ORCID iD: 0000-0002-6404-389X
SPIN-code: 7746-1226

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, Moscow

Natalya P. Teplyuk

Sechenov First Moscow State Medical University (Sechenov University)

Email: teplyukn@gmail.com
ORCID iD: 0000-0002-5800-4800
SPIN-code: 8013-3256

MD, Dr. Sci. (Med.), professor

Russian Federation, Moscow

Petr V. Tsarkov

Sechenov First Moscow State Medical University (Sechenov University)

Email: tsarkov@kkmx.ru
ORCID iD: 0000-0002-7134-6821
SPIN-code: 7570-0664

MD, Dr. Sci. (Med.), professor

Russian Federation, Moscow

References

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Supplementary files

Supplementary Files
Action
1. Fig. 1. Magnetic resonance imaging of the pelvic organs with intravenous contrast in the anteroposterior and lateral views: the cavity is located in the thickness of the subcutaneous fat, slightly shifted to the left of the midline (indicated by an arrow).

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2. Fig. 2. Appearance of the patient: (a) axillary region on the left; (b) patient’s posterior view.

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3. Fig. 3. (a–d) the size of the wound after excision of the sacrococcygeal fistula; (e, f) suturing and the final view of the wound; g — removed specimen (the main cavity extends to the coccyx with tight fixation to it).

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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