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Pacemaker twiddler: a twist in the tail?

1988; BMJ; Volume: 297; Issue: 6664 Linguagem: Inglês

10.1136/bmj.297.6664.1642

0959-8138

Martin Been, P. G. G. Darke,

Cardiac Arrhythmias and Treatments

Pilonidal disease was first described in 1847.Al- though it is common in the sacrococcygeal region of the natal cleft, it is a ubiquitous disorder that has been described in the perineum, the suprapubic region, the axilla, the umbilicus, and the interdigital clefts of barbers' hands.2Pilonidal disease of the areola is rare.There is a report of a pilonidal sinus caused by a dog hair in a canine beautician3 and a similar report in roustabouts (sheepshearers' assistants, who carry shorn wool close to their breast), which also mentions two cases of pilonidal breast disease in hairdressers.4Interestingly, our patient had recently begun to cut men's hair.This is in keeping with the observations of Currie et al, who found interdigital sinuses in men's but not women's hairdressers.5Our patient should be able to prevent recurrence by wearing closely woven nylon overalls that prevent the passage of hair through clothing.Failing that the roustabouts' technique of using wide strips of sticking plaster to cover their nipples might be effective.In this report the history and clinical finding of hair in the mammary ducts rather than in the cavities of the abscess indicated that the abscesses were pilonidal.Despite the clear history, however, the condition was extremely difficult to diagnose, and pilonidal disease _,........... Nipple showingprotruding hatrs may cause periareolar inflammation and abscesses more frequently than has been recogniised.