Orocutaneous Fistula or Traumatic Infectious Skin Lesion: A Diagnostic Dilemma

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Abstract

Orocutaneous fistula (OCF) (of dental origin) is an uncommon but well-described condition in the literature. These are often misdiagnosed by physicians and dentists. Careful selection of investigating modality is important in case of diagnostically challenging cases. A 19-year-old female came with a complaint of a lesion on the chin reported with h/o trauma with the impact on chin presented as diagnostic dilemma because of unusual case history and clinical examination. Commonly used radiographic investigations like IOPA and orthopantomograph did not resolve the dilemma whereas advanced imaging modality like CT scan, 3D volume imaging, and contrast enhanced CT played an important role in the diagnosis of OCF and selecting the treatment plan.

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Cutaneous sinus tracts of dental etiology.

G McWalter, J Alexander, C E del Rio … (1988)

Intermittently draining cutaneous sinus tracts in the area of the face and neck may be caused by chronic dental infection. Diagnosis of the cause may be challenging but is the key to successful therapy. Two cases of these uncommon lesions are presented; one involved a mandibular molar and the other a mandibular incisor. Nonsurgical endodontic treatment was performed. Healing was rapid and uneventful.

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Is Open Access

Dental infection simulating skin lesion

Allan Abuabara, Celso Alfredo Schramm, João Zielak … (2012)

Orocutaneous fistulas or cutaneous sinus, a tract of dental origin, is an uncommon but welldocumented condition that usually requires emergency treatment. Such condition may be misdiagnosed by physicians and dentists and may sometimes be confused with bone and skin tumor, osteomyelitis, congenital fistula, salivary gland fistula, pyogenic granuloma, infected cyst, deep mycotic infection, and other pathologies. A case of facial sinus tract that was initially misdiagnosed by a physician as a nonodontogenic lesion is presented. Nonsurgical endodontic therapy was the treatment of choice for this case. Facial cutaneous sinus tracts must be considered of dental origin. Early diagnosis and prompt treatment minimize patient discomfort and esthetic problems, reducing the possibility of further complications such as sepsis and osteomyelitis.