An odontogenic cutaneous fistula (OCF) may present a number of diagnostic and management challenges.

Clinical features:

(1) chronic bacterial dental infection (apical periodontitis, other)

(2) fistula track communicating to the skin surface

(3) purulent drainage

(4) variable granulation tissue at the skin terminus, which may be mistaken for a skin tumor

(5) variable dental or facial pain


Infections are often mixed aerobic and anaerobic.


Related problem: fistula to maxillary sinus


Differential diagnosis:

(1) basal cell or squamous cell carcinoma (which can arise along a chronic fistula track)

(2) subcutaneous abscess

(3) pyogenic granuloma

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