(Last Updated On: November 13, 2018)

Authors: Rachelle C. Ramilo, Camille B. Angeles, Lian C. Jamisola, Cindy Jao Tan, Maria Nina F. Pascasio

Abstract

Introduction: Interdigital pilonidal sinus (IPS) is an acquired condition secondary to penetration of hair fragments into the skin of the web spaces of the hands commonly observed in hairdressers, and occasionally, among pet groomers. Local literature reports or guidelines to ensure practice of protective measures for this population of workers are currently lacking. Psychosocial sequelae among patients i.e. discomfort and embarassment, necessitate a thorough dermatologic consult.

Case summary:  A 24-year old left-handed pet groomer sought consult due to occasional white hair strands emerging from two 2-mm external openings approximately 1 cm apart located in the third interdigital space of his dominant hand. Histopathologic examination of the sinus tract showed an acanthotic, hyperplastic epidermis with scale crust, and nodular dermal infiltrates composed of epitheliod histiocytes, plasma cells, lymphocytes, and eosinophils. Transepidermal extrusion of polarizable hair cortical material was also evident establishing the diagnosis of an IPS. Sinusectomy and debridement with healing by secondary intention resulted in an optimal wound closure and full motion of the affected hand after one week. Seven months after sinusectomy, there was minimal scarring with no note of recurrence.

Conclusion: Occupational hazards such as IPS may cause functional and psychosocial consequences. Increased awareness among dermatologists leads to more accurate diagnosis, optimal treatment, and proper patient education. Pet groomers should be advised with proper measures to prevent formation or recurrence of a sinus, including but not limited to wearing gloves and prompt removal of embedded hairs during the working day. Surgical excision followed by proper wound care is essential to avoid recurrence.

 

Citation

 

Keywords

pilonidal sinus, interdigital web space, pet groomer, occupational disease

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