Follicular occlusion syndrome in the practice of a coloproctologist

BACKGROUND: Pilonidal disease is the 4th most common disease among inpatient coloproctological patients and surgery remains the “gold standard” of its treatment. However, patients with pilonidal disease often have combined conditions with other follicular occlusion diseases which are most often encountered by dermatologists in their practice. In most cases it is difficult to treat follicular occlusion syndrome with pilonidal disease within one specialty. We demonstrate the complexity of follicular occlusion diseases diagnostics in combination with pilonidal disease, systemize the diagnostic protocol for patient management and present the treatment strategy for coloproctologists.

CLINICAL CASE DESCRIPTION: There was one case of patient with pilonidal disease combined with other conditions of follicular occlusion syndrome noted in the clinic of coloproctology and minimally invasive surgery. Surgery was the first step. There were no complications in the early postoperative period. After hospital discharge, the patient was consulted by a dermatologist, and local and systemic conservative therapy was prescribed for concomitant diseases, which resulted in a significant improvement. There have been no recent reports of recurrence.

CONCLUSION: The treatment of follicular occlusion syndrome with pilonidal disease requires a multidisciplinary approach. At the same time the optimal treatment for pilonidal disease is radical excision of all altered tissues. In cases of such diseases as hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp treatment should be comprehensive and begin with a dermatologist consultation.