Differences between male and female patients with pilonidal disease

作者：Bill Chiu, Claire Abrajano, Hiroyuki Shimada, Razie Yousefi, Kyla Santos Dalusag, Madeline Adams, Wendy Su, Thomas Hui, Claudia Mueller, Julie R. Fuchs, James Dunn · 发表于：Journal of Pediatric Surgery Open · 年份：2024 · DOI：10.1016/j.yjpso.2024.100132 · 被引用次数：10 · 研究领域：Anorectal Disease Treatments and Outcomes、Pelvic floor disorders treatments、Hidradenitis Suppurativa and Treatments

• Pilonidal disease has different presentations between male and female patients. • Male and female pilonidal patients differ in pain intensity, drainage, and granuloma formation. • Female patients can have menstruation-related gluteal cleft pain, possibly ameliorated by hormonal contraceptive use. • Menstruation-related gluteal cleft pain could be due to more fibroblasts with androgen and estrogen receptor expression. Pilonidal disease begins in puberty when males and females have different sex hormone expression. We hypothesize that sex differences can lead to clinical differences in pilonidal disease. Patient demographics, Fitzpatrick skin type, hair characteristic, presentation, pain score, recurrence were recorded 2019–2022. All patients underwent regular epilation+/-pit excision. Excised pits were stained for estrogen receptor, progesterone receptor, and androgen receptor. 237 patients (110F, 127 M) were followed 351±327days. Females present younger than males (17.5 ± 3.9 vs.18.4 ± 3.6years). While no sex-related differences noted in recurrence rate (4.5% vs.7.9 %) or skin type, there were significant sex-related differences in hair amount, thickness, density, and color. More males had granuloma than females (34% vs.12 %): 63 % granuloma were located left of midline, 30 % right, 7 % center. More males than females presented with drainage (67% vs.35 %). Significant differences were noted in patient-reported pain: Females’ mean initial pain score was higher than that of m...