[Pilonidal cysts. Etiology, treatment and results of operation].
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BACKGROUND: An apparatus that generates ultra-high frequency current waveform [radiofrequency] has emerged as a new tool to deal with many of the common ano rectal conditions. OBJECTIVE: The purpose of this paper is to enumerate the benefits of radiofrequency with emphasis on its advantages over conventional procedures. Based on extensive personal experience of using radiofrequency surgery in the performance of various anal pathologies, an attempt is made here to relay in narrative form the procedures from a "how-we-do-it" perspective. CONCLUSION: Our experience indicates that radiofrequency surgery not only facilitates but also improves the performance of surgical procedures in treating anal fistula, hemorrhoids, pilonidal sinus, anal papillae, anal polyps, anal warts, anal condylomas, anal antibiomas and papillomas. It significantly shortens operative time, causes negligible intra-operative bleeding, facilitates faster recovery by allowing rapid healing and minimizes the chances of postoperative complications. It permitted us to perform most of the above procedures as a day care surgery. Add to this, its cost-effectiveness coupled with better patient acceptance, radiofrequency surgery, applied judicially, could significantly improve the performance of a proctologist. The technique could be effectively applied in conjunction with conventional maneuvers to better the results of these procedures. Further studies, nonetheless, are called for to define long-term benefits of the treatment. (Tab. 4, Fig. 1, Ref: 36.)
We report on two women with pigmented lesions of the vulva. The histopathology (filiform downgrowth of pigmented epithelial strands two to four cells wide, extending from the interfollicular epidermis and from follicular infundibula; no increased numbers of melanocytes; horn pseudocysts) was specific for Dowling-Degos disease. One patient also had acne inversa, and the other patient had been treated surgically for a pilonidal sinus some years before. The spectrum of conditions that should be considered in the differential diagnosis of genital pigmented lesions is discussed. Vulvar melanosis, genital lentigo, malignant melanoma, acanthosis nigricans maligna and benigna and syndromes occurring concomitantly with pigmentation of the mucosa need to be excluded. The association of Dowling-Degos disease with acne inversa, which was recently described for the first time, is discussed.