An unusual case of penile pilonidal sinus: diagnostic challenges and literature review.

Pilonidal sinus is a common condition that typically affects the sacrococcygeal region of young men, whereas involvement of other sites, including the external genitalia, is exceedingly rare. We report the case of a 22-year-old man with a penile pilonidal sinus who had failed to respond to multiple courses of antibiotic therapy. Physical examination revealed a firm white papule with a central pinpoint opening on the dorsal balanopreputial fold. The lesion was surgically excised, and histopathological examination confirmed the diagnosis of pilonidal sinus. The postoperative course was uneventful, with complete healing and no complications. Although rare, penile pilonidal sinus should be considered in the differential diagnosis of suspicious penile lesions, alongside both benign and malignant conditions.