Emengo Pamela, Abrajano Claire, Chiu Bill
Division of Pediatric Surgery, Department of Surgery, Stanford University, CA, USA.
Clin Med Insights Pediatr. 2025 Aug 22;19:11795565251366775. doi: 10.1177/11795565251366775. eCollection 2025.
Problems of the gluteal cleft are often due to pilonidal disease, but at times need to be distinguished from other diseases. We reported a series of adolescent patients with non-pilonidal gluteal cleft pathologies.
We performed a retrospective review of all patients who presented to our pediatric Pilonidal Clinic from 1/2019 to 12/2023. Patients who received a work-up for diseases separate from pilonidal disease were included in our study. Patient demographics, clinical work-up, and treatment outcomes were recorded.
We identified 21 patients who had diagnoses other than pilonidal disease: 4 patients had neurological diseases (schwannoma, central disk protrusion, arachnoid cyst, Tarlov cyst); 7 patients had dermatological diseases (folliculitis, moisture-associated skin damage); 5 patients had inflammatory bowel disease; 4 patients had sacral dimples; and 1 patient had a sacral pressure ulcer. Diagnostic decisions were based on the presence and location of an open wound, history of immobility, presence of gluteal cleft swelling or pit, clinical symptoms of pain or erythema, and other similar lesions on the body. These characteristics were utilized to differentiate the diagnoses and construct a diagnostic algorithm.
We developed a practical diagnostic algorithm for differentiating gluteal cleft pathologies in adolescents, including dermatologic, colorectal, neurologic, and traumatic causes.
臀裂问题通常由藏毛窦疾病引起，但有时需要与其他疾病相鉴别。我们报告了一系列患有非藏毛窦性臀裂病变的青少年患者。
我们对2019年1月至2023年12月在我们儿科藏毛窦诊所就诊的所有患者进行了回顾性研究。接受了与藏毛窦疾病不同疾病检查的患者被纳入我们的研究。记录了患者的人口统计学信息、临床检查情况和治疗结果。
我们确定了21例患有除藏毛窦疾病以外诊断的患者：4例患有神经系统疾病（神经鞘瘤、中央椎间盘突出、蛛网膜囊肿、塔尔洛夫囊肿）；7例患有皮肤病（毛囊炎、与潮湿相关的皮肤损伤）；5例患有炎症性肠病；4例患有骶部酒窝；1例患有骶部压疮。诊断决策基于开放性伤口的存在和位置、活动受限史、臀裂肿胀或凹陷的存在、疼痛或红斑的临床症状以及身体上的其他类似病变。利用这些特征来区分诊断并构建诊断算法。
我们开发了一种实用的诊断算法，用于区分青少年臀裂病变，包括皮肤、结直肠、神经和创伤性原因。
