Axillary pilonidal siınus of a hirsute woman

Letter to the Editor

The terminology of pilonidal sinus was firstly used by Hodges et al.¹ in 1880 after 33 years from Anderson et al who founded a hair in a sacrococcygeal ulcer.² Although it is seen mostly in sacrococcygeal area, it may also occur in seldom anatomical localizations such interdigital area, forehead, scalp, umblicus, clitoris, penis, abdomen, neck and axilla.³
We had presented a hirsute Turkish woman aged 25 in November 2009 with the history and complaint of the intermittent small amount of leakage from her right axilla during the past year. On the physical examination, one small sinus sized 2 mm in diameter in her right axilla was detected. However, it was defined at neither the intergluteal sulcus and nor the other parts of the body. The surgical treatment was performed via eliptic skin incision. Following the total surgical excision the histopathological evaluations confirmed the preassumptive diagnosis of axillary pilonidal sinus (Figure 1, 2). Surgical treatment gives to appropriate choice of treatment partially for the disease having one or two sinuses, besides enabling to absolute histopathological diagnoses. Any perioperative or postoperative complication and recurrence has not been detected during the 46 months follow-up.³
Sion-Vardy et al presented two similar cases of axillary pilonidal sinus one month later, in December 2009. They were a 19-year-old male having the prediagnosis of sebaceous cyst and 22-year-old female having the prediagnosis of lymph node. Both patients had given a history of axillary shaving with razor. Sion-Vardy et al mentioned in their study about that the related previously reported cases were non-hirsute healthy women, aged 17-30 years. However, our presented case in November 2009 is a hirsute 25-year-old woman.⁴
So, according to our point of view, the awareness of the probability of a pilonidal disease even in seldom locations like groins of axilla for both hirsute and non-hirsute patients is very important. The malignant degeneration of the disease is very rare, but when it occurs it has much more poor prognosis comparing with squamous cell carcinoma and regular nonmelanoma skin cancer.³

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