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Establishing an Association between Polycystic Ovarian Syndrome and Pilonidal Disease in Adolescent Females

Published:August 19, 2022DOI:https://doi.org/10.1016/j.jpag.2022.08.005

      ABSTRACT

      Study Objective

      We sought to determine whether pilonidal disease (PD) is associated with polycystic ovarian syndrome (PCOS) in adolescent females.

      Design

      Retrospective cohort study

      Setting

      Urban tertiary children's hospital

      Participants

      All girls aged 12 to 21 who received a diagnosis of PD and/or PCOS from 2012 to 2019

      Interventions

      Treatment for PCOS and PD

      Main Outcome Measures

      The variables analyzed included age, race/ethnicity, body mass index, age at menarche, tobacco use, payer status, treatment of PCOS and PD, and serum markers of hyperandrogenism and metabolic syndrome.

      Results

      During the study period, 100,043 patients presented to an urban tertiary medical center. Of these patients, 966 were diagnosed with PD, and 219 were diagnosed with both PD and PCOS. Compared with patients with only PD, patients with both diagnoses had a higher body mass index (31.4 vs 27.4 kg/m2; P < .01) and were older (18.76 vs 18.30 years; P = .003). The prevalence ratio for patients with PD having PCOS per the original Rotterdam criteria was 26.1 (CI, 22.0-31.0) and 28.7 (CI, 24.3-33.9) for having PCOS per the modified Rotterdam criteria. Patients with both diagnoses were less likely to receive intervention for PD (OR = 0.22; CI, 0.13-0.37; P < .001).

      Conclusions

      Adolescent females diagnosed with PD are likely to demonstrate features of PCOS. PCOS treatment could positively alter the disease course of PD. As such, surgical providers should consider referring adolescent females with PD to endocrinologists, gynecologists, and adolescent medicine specialists for evaluation of PCOS.

      Key Words

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      References

        • Johnson EK
        • Vogel JD
        • Cowan ML
        • et al.
        The American Society of Colon and Rectal Surgeons’ clinical practice guidelines for the management of pilonidal disease.
        Dis Colon Rectum. 2019; 62: 146-157
        • Stewart A
        • Baker J
        • Elliott D
        The psychological wellbeing of patients following excision of a pilonidal sinus.
        J Wound Care. 2012; 21: 595-600
        • Escobar-Morreale H
        Polycystic ovary syndrome: definition, aetiology, diagnosis, and treatment.
        Nat Rev Endocrinol. 2018; 14: 270-284
        • Schmidt TH
        • Khanijow K
        • Cedars MI
        • et al.
        Cutaneous findings and systemic associations in women with polycystic ovary syndrome.
        JAMA Dermatology. 2016; 152: 391-398
        • Archer JS
        • Chang RJ
        Hirsutism and acne in polycystic ovary syndrome.
        Best Pract Res Clin Obstet Gynaecol. 2004; 18: 737-754
        • Rotterdam
        ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.
        Fertil Steril. 2004; 81: 19-25
        • Ibáñez L
        • Oberfield SE
        • Witchel S
        • et al.
        An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence.
        Horm Res Paediatr. 2017; 88: 371-395
        • Plouffe Jr, L
        Disorders of excessive hair growth in the adolescent.
        Obstet Gynecol Clin North Am. 2000; 27: 79-99
        • Ajmal N
        • Zeib S
        • Shaikh R
        Polycystic ovary syndrome and genetic predisposition: a review article.
        Eur J Obstet Gynecol Reprod Biol. 2019; 3100060
        • Velasco A
        • Dunlape W
        Pilonidal disease and hidradentitis.
        Surg Clin N Am. 2009; 89: 689-701
        • Benhadou F
        • Van der Zee HH
        • Pascual JC
        • et al.
        Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross-sectional study among 2465 patients.
        Br J Dermatol. 2019; 181: 1198-1206
        • Manuelyan K
        • Lavcheva R
        • Gancheva D
        • et al.
        Comorbidities of hidradenitis suppurativa, multidisciplinary approach and patient support: a 3-year single center clinical experience.
        Exp Dermatol. 2017; 26: 15-16
        • Kimball AB
        • Sundaram M
        • Gauthier G
        • et al.
        The comorbidity burden of hidradenitis suppurativa in the United States: a claims data analysis.
        Dermatol Ther. 2018; 8: 557-569
        • Doll D
        • Krueger CM
        • Schrank S
        • et al.
        Timeline of recurrence after primary and secondary pilonidal sinus surgery.
        Dis Colon Rectum. 2007; 50: 1928-1934
        • Ertan T
        • Koc M
        • Gocmen E
        • et al.
        Does technique alter quality of life after pilonidal sinus surgery?.
        Am J Surg. 2005; 190: 388-392
        • Belenkaia LV
        • Lazareva LM
        • Walker W
        • et al.
        Criteria, phenotypes and prevalence of polycystic ovary syndrome.
        Minerva Ginecologica. 2019; 71: 211-223
        • Dumesic DA
        • Oberfield SE
        • Stener-Victorin E
        • et al.
        Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome.
        Endocr Rev. 2015; 36: 487-525
        • Olutunmbi Y
        • Paley K
        • English III, JC
        Adolescent female acne: etiology and management.
        J Pediatr Adolesc Gynecol. 2008; 21: 171-176
        • Teede HJ
        • Misso ML
        • Costello MF
        • et al.
        Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome.
        Hum Reprod. 2018; 33: 1602-1618
        • Aponso S
        • Choo K
        • Lee HY
        PASH treated successfully with infliximab.
        Exp Dermatol. 2018; 27: 22-23
        • Barboza-Guadagnini L
        • Bassas-Vila J
        Hidradenitis suppurativa in the paediatric and elderly population: Our hospital experience.
        Exp Dermatol. 2017; 26: 20-21
        • Ingram JR
        • Jenkins-Jones S
        • Knipe DW
        • et al.
        Population-based clinical practice research datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa.
        Br J Dermatol. 2018; 178: 917-924
        • Garg A
        • Neuren E
        • Strunk A
        Hidradenitis suppurative is associated with polycystic ovary syndrome: a population-based analysis in the United States.
        J Invest Dermatol. 2018; 138: 1288-1292
        • Fadini R
        • Guarnieri T
        • Renzini MM
        • et al.
        P-326 perinatal outcome of 120 children born from oocyte in vitro maturation treatment.
        Hum Reprod. 2010; 25
        • Odedra S
        • Abdullah A
        • Thomson M
        • et al.
        Laser hair epilation: is there a role in pilonidal sinus disease?.
        Br J Dermatol. 2018; 179: 123
        • Semaan HB
        • Bieszczad JE
        • Obri T
        • et al.
        Incidental extraspinal findings at lumbar spine magnetic resonance imaging.
        Spine. 2015; 40: 1436-1443
        • Vitale F
        • Ruggieri P
        LHRH analogues and PCO disease: validity of the use of Enantone depot in the treatment of the disease.
        Acta Eur Fertil. 1992; 23: 293-295
        • Williams T
        • Mortada R
        • Porter S
        Diagnosis and treatment of polycystic ovary syndrome.
        Am Fam Physician. 2016; 94: 106-113
        • de Parades V
        • Bouchard D
        • Janier M
        • et al.
        Pilonidal sinus disease.
        J Visc Surg. 2013; 150: 237-247
        • Steele SR
        • Perry WB
        • Mills S
        • et al.
        Practice parameters for the management of pilonidal disease.
        Dis Colon Rectum. 2013; 56: 1021-1027
        • Montero-Vilchez T
        • Valenzuela-Amigo A
        • Cuenca-Barrales C
        • et al.
        The role of oral contraceptive pills in hidradenitis suppurativa: a cohort study.
        Life. 2021; 697: 1-11
        • Ingram JR
        • Woo PN
        • Chua SL
        • et al.
        Interventions for hidradenitis suppurativa: a Cochrane systematic review incorporating GRADE assessment of evidence quality.
        Br J Dermatol. 2016; 174: 970-978
        • Williams NM
        • Randolph M
        • Rajabi-Estarabadi A
        • et al.
        Hormonal contraceptives and dermatology.
        Am J Clin Dermatol. 2021; 22: 69-80