Bisphosphonate-related osteonecrosis of the jaw presenting as a cutaneous dental sinus tract: a case report and review of the literature

J Am Acad Dermatol. 2010 Apr;62(4):672-6. doi: 10.1016/j.jaad.2008.09.021. Epub 2010 Feb 11.

Abstract

Bisphosphonates are endogenous pyrophosphate analogs that work to inhibit osteoclast activity. They are commonly used in the treatment of patients with bone related diseases, such as solid tumor metastasis and osteoporosis. One of the infrequent but not rare side effects, especially with high doses of bisphosphonates, is osteonecrosis of the jaw. Although predominantly recognized by dentists because of the bony and intraoral manifestations of the disease, it may also present on the skin. We present a case of osteonecrosis of the jaw resembling two flesh-colored papules associated with dental sinus tracts to highlight the clinical manifestations that dermatologists may encounter, and review the literature on this rare but morbid condition.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Cutaneous Fistula / etiology*
  • Diphosphonates / adverse effects*
  • Female
  • Fistula / etiology*
  • Humans
  • Jaw Diseases / chemically induced*
  • Jaw Diseases / complications*
  • Jaw Diseases / pathology
  • Osteonecrosis / chemically induced*
  • Osteonecrosis / complications*
  • Periapical Diseases / etiology*

Substances

  • Diphosphonates