Pilonidal cyst

Introduction to hair follicles The sinus sinus and the hair follicle are collectively called the pillaroid disease (pilonidaldisease), which is a chronic sinus or cyst in the appendix. The hair is characteristic. It can also be manifested as an acute abscess in the appendix, which forms a chronic sinus after piercing, or temporarily heals, and finally wears out, so recurrent. The cyst is accompanied by granulation tissue, which has an increased number of fibers and often contains a tuft of hair. It is good for men who are moderately obese in 20 to 30 years old. Of course, any age and sex can be affected. There are still differences in the etiology of this disease. The current popular opinion is an acquired disease, because the hair grows into the skin or under the skin. The tissue makes the cyst susceptible to infection and the sinus is not easy to heal. Some people think that it is a congenital disease, because the medullary canal or the development of the appendix is deformed to cause skin inclusions, but in the midline of the baby, the posterior anal and posterior fossa is rarely found in the predator lesions. Most of the diseases occur in men with perineal perineum and hairy hips. At the same time, hair growth and sebaceous gland secretion increase, and there are often infections, irritations and hair loss in deep tissues. Therefore, the viewpoint of acquired diseases is more acceptable. Of course, there are also cases in which the hair follicles that have not been infected cannot be completely explained by acquired diseases. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: squamous cell carcinoma

Causes of hair follicles

Developmental reasons (45%):

In the second half of the 19th century, due to the development of embryology, specific lesions that occurred at specific sites of the disease were naturally suspected to be caused by developmental causes. There are roughly three hypotheses that can be summarized in a large number of writings: 1. The theory of cystic residue in the sacral sacral canal. In 1887, the French scholars Tourneaux and Herrman proposed that until 1942, the American scholar Kooistra still supported this. 2. The development of central sutures in the appendix The theory of Fere (1878) suggested that the development of the central joint deformity in the appendix caused the formation of cysts in the skin. In 1935, Fox advocated this theory. 3. Degenerate remnants resembling the structure of the tail gland of birds. Stone proposed this theory in 1931.

Degradation of a certain gland (30%):

Some people think that it is a degenerate remnant of a certain gland. It was not until 1946 that Patey et al. reported that a hairdresser found a congenital pathogen or a developmental cause after a sinus finger on his finger. The hypothesis began to be suspected and sought to explain the cause of acquisition. There are quite a lot of such reports in the future. It is believed that secondary hair implantation after skin injury is implanted in a healthy search or that the hair is worn through the skin to cause infection and skin. Bearley believes that the sinus sinus is initially formed by the surrounding hair piercing the skin to form a short sinus, while the root of the hair is still connected to its hair follicle. When this hair falls off, it continues to be inhaled by the attraction created by the sinus. He suggests a hypothesis called invasive sinus in the first stage and inhalation sinus in the second stage. Some clinical phenomena and historical facts that have been known, such as the male-dominated disease, occur mostly in people or races with many body hairs. The site of occurrence is a hairy area, and is a site that is often subjected to sputum and friction. Bearley said that the high incidence of jeep occupants is because these soldiers are riding on low and hard jeep on long and bumpy roads, often twisting and rubbing the hips. He has measured changes in local pressure when the gluteal groove is opened. When the buttocks are separated to the sides, the partial pressure can be suddenly reduced by 80 mm H2O. Explain that this part can produce the attraction of cockroaches. At a seminar in 1975, Rord reported that a case of hair was removed from the sinus of the sinus. A total of 23 hairs were consistent in color, length and direction. He thought it was from a "young-type" hair follicle. The "young-type" hair follicle that grows continuously does not start functioning in the fetal period like the "head-type" hair follicle, but starts to function in the youthful sprouting period. It takes about 3 to 6 months for each hair to grow to fall off. While the hair is still growing, the sinus infection, the hair is exposed, he thinks it is difficult to accurately cut the hair follicles when the histological examination or the hair follicle structure has been destroyed when cut, so the general pathological report always says Only hair has no hair follicles. Rord's report shows that there are still many problems waiting to be explained in the traditional etiology.

Hair follicle prevention

1. Prevent infection, strengthen exercise, enhance physical fitness, improve autoimmune function and regular life.

2, to maintain a good attitude is very important, to maintain a comfortable, optimistic, open-minded spirit, strong confidence to overcome the disease. Don't be afraid, only in this way can you mobilize your subjective initiative and improve your body's immune function.

3, pay attention to skin hygiene, strengthen physical exercise, and enhance the skin's resistance.

Conserving hair follicle complications Complications squamous cell carcinoma

Cancer is rare in the sinus sinus. Phipshen (1981) has only 32 cases of literature review. The lesions are mostly well-differentiated squamous cell carcinoma. The wound changes should cause suspected cancerous changes, such as ulceration, rapid growth, and sedan. For fungal-like margins, extensive resection should be preferred. Because wounds are widely used for treatment with skin grafts or flaps, abdomen lymphadenopathy should be biopsied to exclude metastasis. If there is metastasis, the prognosis is poor. The literature reports a 5-year survival rate of 51. %, the recurrence rate was 50%, and the abdomen lymph node metastasis was found to be 14% at the time of initial diagnosis.

Symptoms of hair follicles Common symptoms Cysts and tails Acute abscess squamous epithelium

The hair follicles can be asymptomatic without secondary infection. Usually the main and initial symptoms are acute abscesses in the appendix, similar to soft tissue abscesses in other areas. Localized red, swollen, hot, painful and other acute inflammation, more automatic wear and tear out Inflammation subsides after pus or surgical drainage, and the drainage can be completely closed, but most of them appear as recurrent or frequent water to form a sinus or fistula.

The original tube is mostly in the midline of the appendix. The inner wall is scaly epithelium. The tube extends a distance under the skin. It is usually about 2 to 3 cm long. It may have a small abscess or a small branch from the primary tube. The inner wall of the cavity and branch tube is mostly granulation tissue. It is common for hair that is not connected with the surrounding skin to grow from the sinus ostium. The hair cavity is located in the midline, most of which are in a linear orientation, about 1 to 15 cm long, and the cavity wall is formed by tough fibrous tissue. Secondary ducts can be separated from the main cavity to the subcutaneous tissue, often secreted on the surface of the skin, more from the side of the head to extend, a small number can also extend to the anus, which is easy to be confused with the common perianal fistula.

The main diagnostic markers of sinus or sacral hair follicles are acute abscesses in the appendix or chronic sinus that are secreted. Local manifestations of pain, tenderness and inflammatory infiltration are observed in the midline.

Examination of hair follicles

Skin lesions often occur in the appendix, and can also be found in the head, ears, chest, umbilicus and finger toe, which is characterized by subcutaneous cysts. The patient feels pain and can be diagnosed.

At the time of inspection, the hair cavity was seen in the middle position. The histopathological cyst is located in the dermis or subcutaneous tissue, the epidermis of the cyst wall, and the hair shaft is visible in the cyst wall. The lymphocytes, tissue cells and neutrophils are mixed around the cyst to infiltrate the inflammatory cells, and the foreign body giant cells and granulation tissue can be seen.

Diagnosis and identification of hair follicles

Differential diagnosis

Should be identified with sputum, anal fistula and granuloma, sputum grows on the skin, protrudes from the skin, the top is yellow, there are multiple external holes in the sputum, there is necrotic tissue inside, the outer mouth of the anal fistula is close to the anus, the fistula is going to the anus, percussion There is a cord, the internal anal canal has an internal mouth, and there is a history of anorectal pus, while the direction of the sinus sinus is multi-directional to the cranial side, rarely down, tuberculous granuloma is connected to the bone, and X-ray examination shows bone. The quality is destructive, tuberculous lesions are found in other parts of the body, syphilitic granuloma has a history of syphilis, and syphilis is seropositive.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.