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Fordyce spots - Oral Mucosal Lesion
See also in: Overview,Anogenital
Other Resources UpToDate PubMed

Fordyce spots - Oral Mucosal Lesion

See also in: Overview,Anogenital
Contributors: Anand S. Desai MD, Vivian Wong MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Fordyce spots are normal, superficial, ectopic sebaceous glands seen on mucosal surfaces that are not associated with hair follicles. They may affect as much as 80% of the population. Fordyce spots are often found on the oral mucosa, the vermilion of the lips, the inferior eyelids, and the genitals. The spots are usually clustered and asymptomatic.

The likelihood of developing Fordyce spots increases with age; however, these small papules can be seen in patients of any age. Their development can be associated with hormonal changes, and puberty can bring about their onset.

Codes

ICD10CM:
L73.9 – Follicular disorder, unspecified
Q38.6 – Other congenital malformations of mouth

SNOMEDCT:
50584008 – Fordyce's disease

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Sebaceous hyperplasia is another condition due to a proliferation of sebaceous glands and appears as a larger papule or plaque.
  • Lipomas are generally larger, exophytic, unilateral, and soft in texture.
  • Oral lymphoepithelial cysts are usually solitary, exophytic, unilateral, and larger. They occur in the floor of the mouth and posterior lateral tongue, not the usual sites for Fordyce spots.
  • Granular cell tumors are solitary, larger, firm in consistency, and are usually within the substance of the tongue.
  • Candidal plaques have an acute onset, a "stuck-on" appearance, and are not found within the mucosa.
  • Small fibromas and areas of scarring have an indurated texture.
  • Lichen planus of the oral mucosa can present with lacy white reticulated plaques.

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:03/29/2021
Last Updated:04/11/2021
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Patient Information for Fordyce spots - Oral Mucosal Lesion
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Contributors: Medical staff writer

Overview

Fordyce spots are normal large, superficial sebaceous (oil-producing) glands seen on the moist tissue that lines some organs and body cavities (mucosal surfaces). The "spots" are asymptomatic and can be found on the head of the penis, the inner foreskin, and, most commonly, at the border of the lips. These sebaceous glands are not associated with hair follicles. These lesions are asymptomatic, but itching or irritation may occur if people treat the bumps inappropriately.

Who’s At Risk

Fordyce spots can appear at any point in life, but the incidence of appearance increases with age, with the largest prevalence in elderly patients.

Signs & Symptoms

  • The most common location for Fordyce spots is at the border of the lips, especially near the corners of the mouth. Other locations include the back portions of the inner cheeks and inside the mouth, including the tonsils. The head of the penis and inner portion of the foreskin may be affected as well.
  • Multiple (usually less than 10) 1-2 mm, painless, yellowish papules are seen.

Self-Care Guidelines

None necessary.

When to Seek Medical Care

Fordyce spots are normal and non-cancerous (benign), but seek medical evaluation if Fordyce spots become itchy or irritated.

Treatments

  • No treatment is needed.
  • If irritation is noted, mild topical steroids may provide relief but should be used with caution.

References


Bolognia, Jean L., ed. Dermatology, pp.1656. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.672, 786, 805. New York: McGraw-Hill, 2003.
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Fordyce spots - Oral Mucosal Lesion
See also in: Overview,Anogenital
A medical illustration showing key findings of Fordyce spots (Oral and Eye Presentation) : Buccal mucosa, Yellow color, Upper lip
Clinical image of Fordyce spots - imageId=190784. Click to open in gallery.  caption: 'Pinpoint, discrete and confluent, yellow papules on the lower lip and at the oral commissure.'
Pinpoint, discrete and confluent, yellow papules on the lower lip and at the oral commissure.
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