Facial sinus tract mimicking cutaneous cyst or scar: unveiling a dental infection

A 39-year-old man with an unrecognized facial sinus tract under his chin initially presented with an innocuous lesion resembling an acne pimple. The patient's journey began with dermatologic intervention, involving systemic and topical antibiotics. Upon treatment failure, referral to a general dentist revealed a carious lesion on the lower right lateral incisor, prompting further investigation. A subsequent referral to an endodontic specialist led to the diagnosis of a chronic periapical abscess, and an endodontic intervention was initiated. Despite the persistence of intracanal purulent exudate, a strategic application of pure calcium hydroxide was implemented, followed by a temporary seal. A two-year follow-up demonstrated complete healing of the periapical lesion and resolution of the extraoral cutaneous sinus tract. The report showcases the intricate diagnostic journey, meticulous endodontic intervention, and successful management of an extraoral cutaneous sinus tract mimicking scar or cyst, emphasizing the importance of a correct diagnosis to avoid ineffective treatment.