Tubercular etiology in a pilonidal sinus of the forehead: truth or myth?

Pilonidal sinuses are a well-described surgical condition first recognised in the 19th century. They have most commonly been reported in the intergluteal cleft; involvement of other sites is limited to isolated case reports. Association of this condition with tuberculosis is rare and how the two conditions affect each other's causation is poorly understood. We report a rare case showing tubercular pathology in a chronic pilonidal sinus on the forehead of a young lady. A careful review of the lesion was required before labelling it as non-tubercular. The histopathological similarity between a foreign body reaction and tuberculosis in such lesions may confuse the clinician, and therefore differentiation is important to prevent morbidity associated with anti-tubercular therapy.