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The patient was operated on under general anesthesia. Bilateral second web zig-zag incisions were made. Both the sinuses had an external opening on the second web. The sinus and fistula tracts were totally excised, the chronic inflammatory tissue around the sinus tracts was also excised, and debridement, curettage and irrigation were performed. The samples were sent for pathology and culture. In addition, the ulcerative tissue in the left hand was excised, and the surgical defect was closed primarily. When the fistula tract was opened, there were multiple hairs in it (Figure 2). Staphylococcus aureus was proliferated in the culture taken from the ulcerative lesion on the left hand. Oral trimethoprim/sulfamethoxazole 800/160 mg was given twice a day for two weeks. According to the pathology report, there was a significant increase in the fibrocollagenous connective tissue, and a foreign body giant cell reaction developed against the hair shaft with granulation tissue containing acute and chronic inflammatory cells; the sinus tracts were surrounded by squamous epithelium with no hair follicles.

Bilateral interdigital pilonidal sinus of the hand in a male hairdresser