Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Odontogenic cutaneous fistula of the face

Keiichi Ohta and Hitoshi Yoshimura
CMAJ November 18, 2019 191 (46) E1281; DOI: https://doi.org/10.1503/cmaj.190674
Keiichi Ohta
Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hitoshi Yoshimura
Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF
Loading

An otherwise healthy 61-year-old woman was referred to us by her dermatologist with a 6-month history of an enlarging nodule of the left cheek. The patient was aware of slight mobility of the left posterior maxillary teeth. She had no alcohol or drug problems and was not homeless. Her oral health knowledge and attitude were good. Extraoral examination showed an erythematous, crusted nodule measuring about 50 mm with pus discharge on the left cheek (Figure 1A). Intraoral examination showed swelling of the left posterior maxillary buccal gingiva and hypermobility of the left maxillary teeth without pain (Figure 1B). Computed tomography showed radiolucency in the periapex and perforation of the buccal cortical bone of the left maxillary teeth with surrounding soft-tissue edema that was consistent with the site of the cutaneous nodule (Appendix 1, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.190674/-/DC1). Blood examination did not show any major abnormalities. Odontogenic cutaneous fistula was diagnosed. Cefdinir was administered for 12 days, and the patient underwent extraction of the infected teeth. Nine days later, the nodule was resolved, with no complications.

Figure 1:
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1:

(A) Erythematous, crusted cutaneous nodule measuring about 50 mm on the left cheek of a 61-year-old woman with an odontogenic cutaneous fistula. (B) Swelling and redness of the left posterior maxillary buccal gingiva (arrow).

Odontogenic cutaneous fistula is a rare extraoral path of chronic dental infection caused by an untreated tooth.1–3 It is more common among middle-aged and older adults and women.3 Most cases occur as a nodule in the mandibular angle or chin.3 Only about 50% of patients present with a history of toothache.1 The lesion is often misdiagnosed as being of nonodontogenic origin, which results in inappropriate treatment, such as a prolonged course of antibiotics and repeated surgical treatment.1 Identifying a heavily decayed, discoloured or mobile tooth leads to suspicion of odontogenic origin. Radiologic examination shows a radiolucent lesion in the periapex of the affected tooth.1 The differential diagnosis includes pyogenic granuloma, tuberculous infection, salivary gland fistula, suppurative lymphadenitis and carcinoma.1,2,4 Treatment of the infected tooth leads to resolution within 2 weeks.1

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

  • The authors have obtained patient consent.

References

  1. ↵
    1. Sammut S,
    2. Malden N,
    3. Lopes V
    . Facial cutaneous sinuses of dental origin — a diagnostic challenge. Br Dent J 2013;215:555–8.
    OpenUrl
  2. ↵
    1. Kishore Kumar RV,
    2. Devireddy SK,
    3. Gali RS,
    4. et al
    . Cutaneous sinuses of cervicofacial region: a clinical study of 200 cases. J Maxillofac Oral Surg 2012;11:411–5.
    OpenUrl
  3. ↵
    1. Guevara-Gutiérrez E,
    2. Riera-Leal L,
    3. Gómez-Martínez M,
    4. et al
    . Odontogenic cutaneous fistulas: clinical and epidemiologic characteristics of 75 cases. Int J Dermatol 2015;54:50–5.
    OpenUrlCrossRefPubMed
  4. ↵
    1. Lee EY,
    2. Kang JY,
    3. Kim KW,
    4. et al
    . Clinical characteristics of odontogenic cutaneous fistulas. Ann Dermatol 2016;28:417–21.
    OpenUrl
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 191 (46)
CMAJ
Vol. 191, Issue 46
18 Nov 2019
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Odontogenic cutaneous fistula of the face
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Odontogenic cutaneous fistula of the face
Keiichi Ohta, Hitoshi Yoshimura
CMAJ Nov 2019, 191 (46) E1281; DOI: 10.1503/cmaj.190674

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Odontogenic cutaneous fistula of the face
Keiichi Ohta, Hitoshi Yoshimura
CMAJ Nov 2019, 191 (46) E1281; DOI: 10.1503/cmaj.190674
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Azathioprine-induced severe anemia potentiated by the concurrent use of allopurinol
  • Schwannoma of the tongue
  • “Superscan” in diffusion-weighted imaging with background body suppression magnetic resonance imaging
Show more Practice

Similar Articles

Collections

  • Sections
    • Clinical Images
  • Topics
    • Infectious diseases
    • Oral health
    • Family medicine, general practice, primary care
    • Emergency medicine

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire