Simultaneous Occurrence of Periodontal and Skin Abscesses in a Nigerian Girl: Case Report

Abstract

We report a case of a girl with a perplexing clinical feature of simultaneous occurrence of periodontal and skin abscesses that resolved following periodontal therapy. Infections and inflammations have the capacity to metastasize and despite the localized nature of periodontal disease, infection of the sulcus/periodontal pocket can lead to inflammatory responses beyond the periodontium. C-Reactive Protein (CRP) is primarily a non-specific marker of inflammation with multiple pro-inflammatory properties and some studies have noted its concurrent reduction and CVD following periodontal therapy. A 12 year old Nigerian girl presented clinically with simultaneous occurrence of aggressive periodontitis, periodontal and skin abscesses with eventual teeth loss. Pre-operative quantitative analysis of plasma CRP was 1500mg/l, moderate growth of Staphylococcus aureus and Porphyromonas gingivalis were isolated from the skin and periodontal pus respectively and basic heamatological values were within normal range. Intensive non-surgical periodontal therapy was done at intervals of two months complemented with high dose of Amoxicillin and Metronidazole for seven days. The periodontal condition resolved, skin abscesses healed with scarring and the removable acrylic partial dentures delivered improved the patient’s appearance and eventual overall quality of life. This case may suggest a possible link between periodontal and skin disease because of the resolution of these conditions and concurrent lowering of the serum level of CRP following periodontal therapy. Periodontal disease may be implicated as an etiology of the skin abscess because of the resolution of these disease conditions following periodontal therapy.

Keywords: Case report, Periodontal abscesses, Skin abscesses, CRP, Non-surgical periodontal therapy, Resolution