Pilonidal Cyst of the Umbilicus

An obese 17-year-old boy sought treatment of an apparent abscess of the umbilicus. Hot soaks, black salve, and oral cephalexin were prescribed. Although there was some drainage, the lesion persisted and the patient returned for further evaluation.

Robert P. Blereau, MD of Morgan City, La, noted a red cyst in the umbilicus. The patient was given a local anesthetic and the cystic area was marsupialized; several pieces of hair were revealed within the cyst cavity. The base of the cyst was destroyed with electrocautery.

After the procedure, hot compresses and mupirocin ointment were used for 2 to 3 weeks until re-epithelization was complete.

Pilonidal cysts most commonly arise in the sacrococcygeal area; occurrence at the umbilicus is uncommon.

These lesions have also been reported in the axilla, clitoris, soles, anal canal, interdigital webs of barbers' fingers, and interdigital webs of the toes.

FOR MORE INFORMATION:

• Sabiston DC, Lyerly HK. Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 15th ed. Philadelphia: WB Saunders Company: 1997:1130-1334.