Introduction:
Cutaneous sinus tracts of dental origin are relatively uncommon and are often initially misdiagnosed and inappropriately treated, due to their rarity and the absence of specific symptoms (1).
This condition is defined as a pathologic canal leading from an enclosed area of inflammation or infection that opens to an epithelial surface of the face or the neck. (2)
Odontogenic cutaneous sinus tracts occur as a sequela of bacterial invasion of the dental pulp. Necrotic affected teeth exhibit apical periodontitis due to spread of infection into the periarticular area. The infection follows the path of least resistance between facial spaces, desiccate and breakthrough the skin to form draining sinus tracts. (3)
A review of several reported cases showed that patients may undergo multiple unnecessary attempts of surgical excisions, drainage, biopsies, and long-term use of antibiotics with no remission, due to improper diagnosis and the lack of treatment of the infectious dental origin. (4,5). Besides, in most cases, cutaneous sinus tracts of dental origin may not have any apparent dental symptoms and may progress over a long period of time without alarming the patient.
The aim of this paper was to present a case of a misdiagnosed cutaneous sinus tract related to an infected radicular cyst and which was inappropriately treated for 4 years without any remission, and to highlight the importance of considering chronic dental infections as part of differential diagnosis for any orofacial skin lesion.