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Authors
Advisor(s)
Abstract(s)
Introdução: O sinus pilonoidal da vulva (SPV) é uma patologia rara, existindo
apenas alguns casos descritos na literatura. Resulta da penetração e crescimento de pelos
para dentro da pele, originando uma reação inflamatória do tipo corpo-estranho, que pode
infetar e provocar um abcesso agudo com trajetos fistulosos. O diagnóstico em geral é
clínico tendo por base a história clínica, o exame físico, a evolução dos sintomas e a presença
de fatores de risco. O diagnóstico definitivo é histopatológico. O tratamento definitivo é a
excisão cirúrgica em bloco da lesão com encerramento primário da mesma ou com
cicatrização por segunda intenção. O prognóstico é habitualmente favorável, embora tenha
alta taxa de recorrência.
Objetivo: Descrever o caso clínico de uma mulher com o diagnostico histológico de
SPV, e comparar as características clínicas deste caso, com as características dos casos
descritos na literatura
Métodos: Recolha dos dados clínicos da doente, de forma retrospetiva, tendo sido
analisados os sintomas, as alterações físicas e o relatório anatomopatológico da peça
excisada. Procedeu-se também à análise de artigos publicados no Pubmed, em língua
inglesa e portuguesa para a avaliação da evidência científica atual sobre SPV.
Resultado: A doente de 86 anos com diagnóstico prévio de líquen plano da vulva,
estava medicada com corticoide local desde há vários anos. Foi efetuada a excisão cirúrgica
completa da lesão e encerramento primário da mesma. O exame histopatológico identificou
a lesão como sendo um SPV. O pós-operatório não teve intercorrências, a doente apresentou
uma boa cicatrização, sem queixas e sem recorrência da lesão nos seis meses de seguimento.
Este caso clínico distingue-se dos restantes descritos na literatura, devido à idade de
aparecimento do SPV, à localização do SPV e à existência de múltiplas comorbilidades, tais
como o líquen plano da vulva sob corticoterapia crónica.
Conclusão: O SPV é uma patologia extremamente rara, e por essa razão o
diagnóstico deste caso foi efetuado apenas pela histologia. Visto que se trata de uma
patologia tão rara a suspeição clínica, um diagnóstico precoce e um tratamento atempado e
individualizado da mesma são fundamentais para evitar complicações médicas associadas.
Introduction: Vulval pilonidal sinus (VPS) is a rare condition with only a few cases described cases in literature.It results from the penetration and growth of hair into the skin, originating a foreign-body-type inflammatory reaction, which can infect and cause an acute abscess with fistulous tracts. The diagnosis is generally clinical, based on the clinical history, physical examination, the evolution of symptoms and the presence of risk factors. Definitive diagnosis is histopathological. Definitive treatment is block excision of the lesion with primary closure or healing by secondary intention. The prognosis is usually good, although it has a high recurrence rate. Objectives: To report the clinical case of a woman with the histological diagnosis of VPS, and to compare its clinical characteristics with those described in the literature. Methods: Retrospective analysis of the patient's clinical data, including symptoms, physical changes and the anatomopathological report of the excised piece. Additionally, articles published in Pubmed in English and Portuguese with current scientific evidence on the VPS were analyzed. Results: The 86-year-old patient, previously diagnosed with vulvar lichen planus, had been taking local corticoids for several years. Complete surgical excision of the lesion and primary closure were performed. The histopathological examination identified the lesion as a pilonidal sinus of the vulva. The postoperative period was uneventful, the patient had good healing, no complaints, and no recurrence of the lesion in the six months of followup. This clinical case differentiates itself from others described in the literature, due to the age of onset of VPS, the location of the VPS and the existence of multiple comorbidities, such as vulval lichen planus under chronic corticotherapy. Conclusion: The VPS is an extremely rare pathology, and therefore the diagnosis of this case was made only by histology. As this is such a rare condition, clinical suspicion, early diagnosis, timely and individualized treatment are essential to avoid associated medical complications.
Introduction: Vulval pilonidal sinus (VPS) is a rare condition with only a few cases described cases in literature.It results from the penetration and growth of hair into the skin, originating a foreign-body-type inflammatory reaction, which can infect and cause an acute abscess with fistulous tracts. The diagnosis is generally clinical, based on the clinical history, physical examination, the evolution of symptoms and the presence of risk factors. Definitive diagnosis is histopathological. Definitive treatment is block excision of the lesion with primary closure or healing by secondary intention. The prognosis is usually good, although it has a high recurrence rate. Objectives: To report the clinical case of a woman with the histological diagnosis of VPS, and to compare its clinical characteristics with those described in the literature. Methods: Retrospective analysis of the patient's clinical data, including symptoms, physical changes and the anatomopathological report of the excised piece. Additionally, articles published in Pubmed in English and Portuguese with current scientific evidence on the VPS were analyzed. Results: The 86-year-old patient, previously diagnosed with vulvar lichen planus, had been taking local corticoids for several years. Complete surgical excision of the lesion and primary closure were performed. The histopathological examination identified the lesion as a pilonidal sinus of the vulva. The postoperative period was uneventful, the patient had good healing, no complaints, and no recurrence of the lesion in the six months of followup. This clinical case differentiates itself from others described in the literature, due to the age of onset of VPS, the location of the VPS and the existence of multiple comorbidities, such as vulval lichen planus under chronic corticotherapy. Conclusion: The VPS is an extremely rare pathology, and therefore the diagnosis of this case was made only by histology. As this is such a rare condition, clinical suspicion, early diagnosis, timely and individualized treatment are essential to avoid associated medical complications.
Description
Keywords
Doença Pilonidal Quisto Pilonidal Sinus Pilonidal Vulva