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July 15, 1988

Idiopathic Cellulitis of Facial Soft Tissue-Reply

Author Affiliations

San Francisco

San Francisco

JAMA. 1988;260(3):339. doi:10.1001/jama.1988.03410030054018

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In Reply.—  Dr Deutsch's patient had a history of severe pain and swelling on the right side of her face, which responded to four days of antibiotic therapy. Clinical examination after antibiotic therapy revealed a decrease in swelling; however, a tender subcutaneous nodule approximately 2 cm in diameter remained in the midcheek area just lateral to the coronoid process of the mandible.Dr Salon suggests the possibility of internal derangement of the temporomandibular joint or even perforation of the meniscus. It has been my experience in well over 1000 cases of dysfunction of the temporomandibular joint that such problems do not manifest themselves as a tender subcutaneous nodule lateral to the mandible. They also don't respond to antibiotic therapy and trigger points of the muscles involved are not found in the soft tissues of the cheek, which are at some distance from the sites of origin and insertion of the