ABSTRACT
A.W. Anderson’s letter to the editor that appeared in an issue of the Boston Medical Surgical Journal of 1847, entitled ‘‘Hair Extracted From an Ulcer,’’ is believed to be the first documented case of pilonidal sinus (1). The letter described a young 21-year-old man with pain in his back. Anderson found a ‘‘fistula opening’’ near the coccyx on the left side, which was so small that he could not introduce a probe. Upon opening the cavity, he found a large amount of ‘‘very fine, closely matted hairs about 2 in. in length,’’ with very offensive smell. The hairs were removed and the wound healed in three weeks. In 1880, Hodges (2) coined the term ‘‘pilonidal sinus’’ (pilus, meaning hair, and nidus, meaning nest) to describe the chronic sinus containing hair and found between the buttocks. He believed the condition was congenital in origin, representing an imperfect union of the lateral halves of the body and involving the integument only. Buie (3) called it ‘‘jeep disease’’ because of the frequent reactivation of the quiescent sacrococcygeal sinuses among military personnel who entered training for combat duty, with rugged lifestyle and stresses of driving trucks, tanks, and jeeps. The time loss among patients with pilonidal disease was tremendous, ‘‘ . . . a mild ailment, . . . it represents one of the most important surgical courses of lost time.’’ Seventy-nine thousand U.S. servicemen were hospitalized, each for an average 55 days, because of pilonidal disease and its treatment during World War II (4).
