Abdulrahman Aldarkhbani, Zainab K Alkhlaif
Pilonidal sinus disease usually presents in the sacrococcygeal region. Its occurrence at nonsacrococcygeal sites, such as the lower limb, is exceedingly rare and may mimic other benign lesions. We present a 33-year-old man with an unusual presentation of a pilonidal sinus over his leg. Ectopic pilonidal disease should be considered in the differential diagnosis of chronic subcutaneous swellings, particularly when a punctum or sinus tract is present. Awareness of such atypical presentations ensures ectopic pilonidal disease is considered in the differential diagnosis for unusual anterior leg lesions.