May 2025, Volume 3, Issue 5

Author

Manav Jindal, Ashutosh Soni, Sanjeev Agarwal, Arjun Chaudhary and Dhruv Dodiya

Abstract

Pilonidal refers to a collection of hair. The pilonidal sinus is a subcutaneous track containing hairs or their microscopic fragments. The sinus penetrates into the subcutaneous layers as a bulbous diverticulum with or without branching side channels. The presence of a hair tuft in the sinus cavity or tract is the characteristic feature of the pilonidal sinus. We describe the case of a 13-year-old paediatric patient in this case study who developed a chronic, intermittently discharging sinus tract on the dorsum of the nose, Magnetic resonance imaging (MRI) of PNS showed a localized blind subcutaneous tract over the dorsal aspect of nose. A tiny area of abnormal signal intensity along the dorsal aspect of lower 1/3rd of nose reaching upto skin surface, however no obvious intranasal cavity opening or aspirable pocket or collection noted, possibly sinus tract. The patient has a presence of a sinus tract over the dorsum of nose; surgery was performed with exploration of the sinus by injecting methylene blue dye which subsequently facilitated a precise excision, ensuring complete removal of the sinus, through external rhinoplasty approach. Histopathological analysis revealed a sinus tract lined with keratinized stratified squamous epithelium containing a tuft of hair, patient was followed up for three months; without any complaint of any complication or recrudescence.