殿部毛巣洞の女性発症例についての検討

Pilonidal Disease in Women: Seven Cases

はじめに

　毛巣洞は毛を含む瘻孔，囊腫を形成する疾患で，多毛や肥満がある若年の男性に好発し 1）～3），女性例は比較的まれとされる。今回，われわれが手術を行った女性の毛巣洞症例について検討を行い，興味深い結果を得た。女性の毛巣洞症例も男性同様に多毛や肥満を伴っているとされるが，今回われわれの経験した女性例7例中，多毛が3例，非多毛が4例であった。女性の毛巣洞について文献的考察を行ったので報告する。

　Pilonidal disease is commonly observed in young men with risk factors such as hirsutism or obesity, but its occurrence in women, particularly in those without these risk factors, is rare and not well-documented. We review seven cases of pilonidal disease in women aged 16–24 years treated at our institution and affiliated facilities. Three of the patients had hirsutism; two patients had mild obesity (BMI 25–30). None of the patients exhibited both hirsutism and obesity. Unlike male cases, in whom extensive lesions often require local flap reconstruction, the pilonidal disease of all seven females was successfully treated with primary closure. The diagnosis was confirmed in all cases by MRI and a histopathological examination, and complete surgical excision was performed for each patient under general anesthesia. To prevent recurrence and wound dehiscence, the postoperative management included compression, prone positioning, and in some cases, laser hair removal, resulting in no recurrences during follow-up (5-12 months). These findings highlight the need to consider pilonidal disease as a differential diagnosis for sacrococcygeal lesions in women, regardless of the presence/absence of typical risk factors. The proper diagnosis, surgical management, and postoperative care are essential to prevent misdiagnosis and recurrence, ensuring optimal patient outcomes.