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Fordyce spots - Oral Mucosal Lesion
See also in: Anogenital
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Fordyce spots - Oral Mucosal Lesion

See also in: Anogenital
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Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed

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Synopsis

Fordyce granules are normal, superficial sebaceous glands seen on mucosal surfaces of approximately 80% of the population. Because they are so prevalent, their occurrence is considered a normal anatomic variation. Fordyce granules are usually multiple and clustered, and are often found on the oral mucosa and the vermilion of the lips. They are often also present on the genitalia. They are not associated with hair follicles.

The tiny papules can appear at any point in life but the incidence of appearance increases with age, probably associated with hormonal influences, with the highest prevalence in older patients. Puberty is associated with the appearance of these lesions, as expected.

The lesions are asymptomatic. They can be present for years and the patient is usually unaware of their presence.

Codes

ICD10CM:
 – Normal Condition -- no billing code

SNOMEDCT:
50584008 – Fordyce spots

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Sebaceous hyperplasia is essentially hyperplasia of one of the Fordyce granules 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 mouth and posterior lateral tongue, not the usual sites for Fordyce granules.
  • 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.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 06/09/2016
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Fordyce spots - Oral Mucosal Lesion
See also in: Anogenital
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Fordyce spots : Buccal mucosa, Lips, Male genital, Yellow color, Tiny papules, Oral papules
Clinical image of Fordyce spots
Pinpoint, discrete and confluent, yellow papules on the lower lip and at the oral commissure.

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