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Association between PCOS and Pilonidal Disease among Adolescent Girls
Naomi Adjei, Nicholas Yung, Gwendolyn Towers, Daniel Solomon, Alla Vash-Margita
Yale New Haven Hospital, Northford, Connecticut, United States

Objective: To examine the relationship between Polycystic Ovarian Syndrome (PCOS) and Pilonidal disease (PD)and to evaluate any phenotypic differences between patients with one or both conditions.
Design: Retrospective Cohort Study.
Setting: Emergency department at an academic institution
Patients: Adolescent females who presented to the pediatric emergency department from 2012 to 2019. A total of 100,043 patient visits were recorded and 978 of these received a diagnosis of PD. Patients with concomitant androgen producing tumors or dermatologic conditions were excluded (n=12). Patients were further categorized based on PCOS chart diagnosis and manual chart review found 199 patients at risk for PCOS of which 159 patients met strict Rotterdam criteria for PCOS.
Main Outcome Measures: The odds of PD patients receiving a PCOS diagnosis compared to patients without PD. Prior to data collection, we also planned on examining surgical procedures to evaluate any phenotypic differences.
Results: Patients with concomitant diagnoses were more likely to have a higher BMI, 31.4 v. 27.4 (p<0.01), and be older, 18.8 v. 18.3 (p=0.04). The odds of patients with PD having PCOS was 34.6 [CI 29.2,40.9] times that of patients without PD (p<0.001). Patients at risk for PCOS were less likely (OR 0.22 [0.13,0.35; p<0.001]) to receive intervention for PD.
Conclusion: There is a higher prevalence of PCOS among adolescent girls diagnosed with PD. PCOS appears to confer a protective effect reducing risk of intervention for PD. This maybe attributable to the treatment patients undergo for PCOS. This study reveals an association of PCOS with PD and identifies a gap in care for adolescent females that should be addressed in the future by any provider dealing with these conditions.
Independent Predictors for Intervention in All Patients


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