Pilonidal disease in siblings - A case series

Pilonidal disease can occur in siblings, and family history of pilonidal disease can predispose to earlier onset of disease. However, there is scant literature regarding the occurrence or presentation of pilonidal disease in siblings. We present the largest case series to date of six sibling pairs with pilonidal disease, including one pair of identical twins. Six sibling pairs were treated for pilonidal disease in our clinic. Of the six sibling pairs, five were same sex siblings and one was opposite sex siblings. The age at presentation ranged from 13.4 to 23.0 years old, with a median age of 15.7 years [interquartile range (IQR): 14.3–20.2]. The median age difference between siblings was 618 days (IQR: 407–1071), with a median length of follow up of 388 days (IQR: 185.5–449.0). The median symptom duration at the time of presentation was 249.5 days (IQR: 131.2–697.5). Four of the 12 patients presented with draining granuloma or secondary sinus, including both of the siblings in the identical twin pair. Eight of the 12 patients were treated with operative management initially, while four were treated non-operatively. None of the patients who underwent initial operative management experienced recurrence. Patients managed non-operatively were treated with regular and laser epilation. All patients who underwent operative management received a Gips procedure followed by regular and laser epilation. Pilonidal disease can occur in siblings, suggesting that it may be associated with genetic predisposition. Additionally, siblings can present with differing severities of pilonidal disease.