Thymoma-associated cutaneous graft-versus-host-like reaction

In spite of the high incidence of pilonidal disease at young population and prolonged disabling period that it demands, colorectal surgeons have not reached consensus about etiology or best treatment for this condition. The authors intend to analyse results from 154 cases operated on at HCFMUSP through a retrospective chart analysis regarding patients' sex, age and race, operative technique, complications and recurrence. Half patients were male. Eighty-three percent were between 11 and 30 yr-old. Incision and curettage was offered to 74.7% of the patients. Excision technique was used in 25.3%. In patients who underwent excision technique, there were no recurrences and a cicatrization defect was diagnosed in 2 (5.1%) patients. For patients who underwent incision and curettage, recurrence was 3.5% and cicatrization defect was seen in 1 (0.9%) case. Excision or incision plus curettage techniques seem to be both effective for treatment of chronic pilonidal disease although the former may produce healing defect more commonly. Patients who present with complex lesions may benefit from excisional techniques associated to skin or myocutaneous flaps in a first attempt instead of conservative approaches.