Cutaneous sinuses of dental origin

Area of Science:

• Oral and Maxillofacial Surgery
• Dermatology
• Infectious Diseases

Background:

• Cutaneous sinuses in the head and neck region can originate from dental infections.
• Misdiagnosis by non-dentally trained professionals can lead to delayed or ineffective treatment.
• Awareness of dental origins is crucial for managing persistent skin lesions in this area.

Purpose of the Study:

• To report a case of a cutaneous sinus secondary to a non-vital lower premolar.
• To emphasize the importance of considering dental causes for unexplained cutaneous sinuses.
• To highlight the need for appropriate referral and diagnostic evaluation.

Main Methods:

• Case report of a patient presenting with a cutaneous sinus.
• Review of diagnostic process and treatment pathway.
• Discussion of differential diagnoses and management strategies.

Main Results:

• The cutaneous sinus was correctly identified as originating from a non-vital lower premolar after referral to an Oral and Maxillofacial clinic.
• Appropriate dental treatment led to rapid resolution of the sinus and associated symptoms.
• Initial non-dental treatment proved ineffective due to misdiagnosis.

Conclusions:

• Dental infections are an important, often overlooked, cause of cutaneous sinuses in the head and neck.
• Healthcare professionals, especially those not dentally qualified, should consider dental etiologies and refer patients with suspicious lesions.
• Thorough history, clinical examination, and appropriate investigations are paramount for accurate diagnosis and effective management.