Background. A periclitoral pilonidal cyst or sinus is an exceedingly infrequent occurrence. Diagnostic criteria consist of a sinus tract or cyst containing hair follicles and inflammatory reaction in one or more partially or completely epithelialized sinus tracts. Follow-up of patients reported in the literature has been too short to provide a consensus in regard to the extent of surgery required to provide permanent cure.
Case. A 30-year-old patient was seen in consultation for evaluation of a chronic, draining periclitoral abscess that had been treated for approximately 2 years with multiple rounds of antibiotics and local incisions. Treatment consisted of a wide local excision of the cyst and multiple sinuses extending into the periclitoral area and labia minora. The shaft and glans of the clitoris were preserved. Primary closure and healing were accomplished.
Conclusion. Diagnosis and curative therapy of a pilonidal cyst of the clitoris require a thorough resection which can be accomplished with preservation of the clitoris.