Resolution of pilonidal disease after bone marrow transplantation: A case report

Pilonidal disease is a common condition in adolescents and young adults that is managed with medications, local wound care and surgery. Immunosuppression is not a standard therapy utilized in this disease but is routinely prescribed in hidradenitis, a folliculitis in the axillae and groin rather than in the gluteal cleft. We present the case of a patient with severe pilonidal disease, with multiple collections in and above the gluteal cleft. Prior to presentation to our clinic, they had failed a standard treatment regimen for three years which included local wound care, multiple courses of antibiotics and incision and drainage procedures. They started on a treatment plan focused on hygiene and hair removal after being evaluated in our clinic. During this time, a concomitant diagnosis of leukemia was made and they were treated with induction chemotherapy and subsequent bone marrow transplant. Their pilonidal disease fully resolved after immunosuppression. This patient's severe pilonidal disease resolved with immunosuppression, supporting an inflammatory basis of the condition.