Sebaceous Cyst-Induced Sinus at Natal Cleft Resemble as Recurrent Pilonidal Sinus: A Case Report

Abstract

Sebaceous cyst (Epidermoid inclusion cyst) is a retention cyst caused due to blockage of the duct of sebaceous gland situated in the dermis and confined to the sub-cutaneous plane with no deeper tissue extensions. Whereas pilonidal sinus (PNS) is a chronic subcutaneous abscess in the natal cleft, which spontaneously drains through the openings. Case report: A 71-year-old female normo-sthenic, non-hirsute, non-diabetic and normotensive patient came to Shalya Tantra OPD with pus discharge from previously operated PNS scar at natal cleft since last 3 months in on/off manner associated with pain and itching. She had a surgical history of pilonidal sinus on 16/10/2022 and 18/12/2023. On examination single opening was present over the post-operative scar at natal cleft, but there was no presence of active discharge or fluid. USG of local part report revealed well defined hypoechoic collection. Up-on excision, the tract was found as sac with foul smelling sebaceous material. Complete excision of tract was performed. In histopathology report the diagnosis was confirmed as sebaceous cyst. Post operatively for intial 3 days antibiotics were given, then shifted to Kanchanara Guggulu, Varunadi Kwath orally and Panchavalkal Malahara for dressing. Patient got complete relief from pain, itching and pus discharge from natal cleft after surgical removal of sebaceous cyst and 20 days of daily dressing and oral conservative treatment. Follow-up was taken upto 7 months.