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((short description|Sebaceous glands that are present in most individuals))
((cs1 config|name-list-style=vanc))
((Distinguish|Angiokeratoma of Fordyce|Fox-Fordyce disease|Pearly penile papules))
((Infobox anatomy
| Name        = Fordyce spots
| Image       = Fordyces spot closeup.jpg
| Caption     = Close-up of Fordyce spots on penis (shaft)
| Width       = 
| Image2      = Fordyce's Spots on Vulva.png
| Caption2    = Fordyce spots on vulva
| Latin       =
| Greek       =
| Precursor   = 
| System      = 
| Artery      = 
| Vein        = 
| Nerve       = 
| Lymph       = 
))

'''Fordyce spots''' (also termed '''Fordyce granules''') are harmless and painless visible [[sebaceous gland]]s typically appearing as white/yellow [[papule|small bumps]] or spots on the inside of lips or cheeks, gums, or genitalia.<ref name=DermNet>((cite web |title=Fordyce spots: Quick and Informative guidance — DermNet |url=https://dermnetnz.org/topics/fordyce-spots |website=dermnetnz.org |access-date=27 April 2023 |language=en))</ref><ref name=Andrew2020>((cite book |last1=James |first1=William D. |last2=Elston |first2=Dirk |last3=Treat |first3=James R. |last4=Rosenbach |first4=Misha A. |last5=Neuhaus |first5=Isaac |title=Andrews' Diseases of the Skin: Clinical Dermatology |date=2020 |publisher=Elsevier |location=Edinburgh|isbn=978-0-323-54753-6 |page=798 |edition=13th |chapter-url=https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA798|language=en |chapter=34. Disorders of the mucous membranes))</ref> They are common,<ref name=Hall2019/> and are present in around 80% of adults.<ref name=DermNet/> Treatment is generally not required and attempts to remove them typically result in pain and scarring.<ref name=Hall2019/>

Their cause is unclear,<ref name=Hall2019>((cite book |last1=Hall |first1=Anthony |title=Atlas of Male Genital Dermatology |date=2019 |publisher=Springer |isbn=978-3-319-99749-0 |pages=15–18 |chapter-url=https://books.google.com/books?id=xIx5DwAAQBAJ&pg=PA15 |language=en |chapter=7. Ectopic sebaceous glands))</ref> and they are not associated with hair follicles.<ref name=Hall2019/> Diagnosis is done by visualisation.<ref name=Hall2019/> They may appear similar to genital warts or [[Molluscum contagiosum|molluscum]].<ref name=Hall2019/> They were first described in 1896 by American [[dermatologist]] [[John Addison Fordyce]].<ref name=Crissey2013>((cite book |last1=Crissey |first1=John Thorne |last2=Parish |first2=Lawrence C. |last3=Holubar |first3=Karl |title=Historical Atlas of Dermatology and Dermatologists |date=2013 |publisher=CRC Press |isbn=978-1-84184-864-8 |page=87 |url=https://books.google.com/books?id=7ThZDwAAQBAJ&pg=PA87|language=en))</ref>

==History==
Fordyce spots are named after the American [[dermatologist]] [[John Addison Fordyce]], who first described them in 1896.<ref name=Fordyce>Fordyce first described them in 1896.((WhoNamedIt|synd|1510))</ref>

==Classification==
Sebaceous glands are normal  structures of the [[human skin|skin]] but may also be found [[ectopia (medicine)|ectopically]] in the [[human mouth|mouth]], where they are referred to as ''oral Fordyce granules'' or ectopic sebaceous glands. 
On the [[foreskin]], they are called [[Preputial gland|Tyson's gland]]s,<ref name=eMedicine>((eMedicine|derm|395))</ref> but should not be confused with [[hirsuties coronae glandis]].<ref name=singapore>((cite journal |vauthors=Khoo LS, Cheong WK |title=Common genital dermatoses in male patients attending a public sexually transmitted disease clinic aka(DC) in Singapore |journal=Annals of the Academy of Medicine, Singapore |volume=24 |issue=4 |pages=505–9 |date=July 1995  |pmid=8849177))</ref>

When they appear on the penis, they are called ''penile sebaceous glands''.<ref name="Rane 2013" />

==Signs and symptoms==
They appear as small, painless, raised, pale, red or white spots or bumps 1 to 3&nbsp;mm in diameter that may appear on the scrotum, shaft of the [[Human penis|penis]], or on the [[labia (genitalia)|labia]], as well as the inner surface (retromolar mucosa) and [[vermilion border]] of the [[lip]]s of the [[face]]. They are not associated with any disease or illness, nor are they infectious but rather they represent a natural occurrence on the body. Therefore, no treatment is required. People with this condition sometimes consult a dermatologist because they are worried they may have a [[sexually transmitted infection]] (especially [[genital warts]]) or some form of [[cancer]].<ref name=Alto>[http://www.pamf.org/FAQ/FAQ/fx=q/id=3419/t=a/c=9/a=13/tid=1/kw=1/z=null/faq.htm Palo Alto Medical Foundation] Bettina McAdoo, M.D. Retrieved June 24, 2006.</ref>

==Description==
[[File:Mancha de Fordyce.jpg|thumb|Fordyce spots on scrotum]]
[[File:Fordyce_Spots_on_Lips.jpg|thumb|Fordyce spots on lips|alt=Close-up of lips with fordyce spots]]
On the shaft of the penis, Fordyce spots are more visible when the skin is stretched, and may only be noticeable during an erection.<ref name="Rane 2013">((cite journal |vauthors=Rane V, Read T |title=Penile appearance, lumps and bumps |journal=Australian Family Physician |volume=42 |issue=5 |pages=270–4 |date=May 2013  |pmid=23781523 |url=http://www.racgp.org.au/afp/2013/may/penile-appearance/))</ref> The spots can also appear on the skin of the scrotum.<ref name="Rane 2013" />

Oral Fordyce granules appear as rice-like granules, white or yellow-white in color. They are painless papules (small bumps), about 1–3&nbsp;mm in greatest dimension. The most common site is along the line between the [[vermilion border]] and the [[oral mucosa]] of the upper lip, or on the [[buccal mucosa]] (inside the cheeks) in the commissural region,<ref name="Scully 2013">((cite book|last=Scully C|title=Oral and maxillofacial medicine: the basis of diagnosis and treatment|year=2013|publisher=Churchill Livingstone|location=Edinburgh|isbn=978-0-7020-4948-4|edition=3rd|pages=170, 392))</ref> often bilaterally. They may also occur on the mandibular retromolar pad and tonsillar areas, but any oral surface may be involved. There is no surrounding mucosal change. Some patients will have hundreds of granules while most have only one or two.((citation needed|date=September 2021))

Occasionally, several adjacent glands will coalesce into a larger cauliflower-like cluster similar to [[sebaceous hyperplasia]] of the skin. In such an instance, it may be difficult to determine whether or not to diagnose the lesion as [[sebaceous hyperplasia]] or [[sebaceous adenoma]]. The distinction may be moot because both entities have the same treatment, although the adenoma has a greater growth potential. [[Sebaceous carcinoma]] of the oral cavity has been reported, presumably arising from Fordyce granules or hyperplastic foci of sebaceous glands.((citation needed|date=September 2021))

In some persons with Fordyce spots, the glands express a thick, chalky discharge when squeezed.<ref name="Rane 2013" />

==Causes==
Normally, sebaceous glands are only found in association with a [[hair follicle]].((citation needed|date=September 2021))

They appear to be more obvious in people with oily skin types,<!-- <ref name="Scully 2013" /> --> with some [[rheumatic disorder]]s,<!-- <ref name="Scully 2013" /> --> and in [[hereditary nonpolyposis colorectal cancer]].<ref name="Scully 2013" /> In the latter, the most common site for Fordyce spots is the lower [[gingiva]] (gums) and vestibular mucosa.<ref name="Scully 2013" />

==Diagnosis==
((Unreferenced section|date=June 2023))
Large numbers of lobules coalescing into a definitely elevated mass may be called benign sebaceous hyperplasia, and occasional small keratin-filled pseudocysts may be seen and must be differentiated from [[epidermoid cyst]] or [[dermoid cyst]] with sebaceous adnexa. The pathologist must be careful to differentiate such lesions from salivary neoplasms with sebaceous cells, such as [[sebaceous lymphadenoma]] and [[sebaceous carcinoma]].

Oral Fordyce granules are usually not biopsied because they are readily diagnosed clinically, but they are often seen as incidental findings of mucosal biopsies of the buccal, labial and retromolar mucosa. The granules are similar to normal sebaceous glands of the skin but lack hair follicles and almost always lack a ductal communication with the surface. The glands are located just beneath the overlying epithelium and often produce a local elevation of the epithelium. Individual sebaceous cells are large, with central dark nuclei and abundant foamy [[cytoplasm]].

===Differential===
Some diseases may appear similar to Fordyce spots such as sexually transmitted infections.<ref name="DermNet NZ">((cite web | title=Fordyce spots | website=DermNet NZ | url=https://dermnetnz.org/topics/fordyce-spots/ | language=af | access-date=2019-12-21 | quote=The importance of recognising these papules as Fordyce spots is in the differential diagnosis of other conditions that may appear similar. Some sexually transmitted diseases (STDs) may start off looking like Fordyce spots on the genitals so it is essential to get a proper diagnosis from your doctor. STDs need to be treated appropriately with medication.))</ref>

== Treatment ==
Most doctors consider this a normal [[physiology|physiological]] phenomenon and advise against treatment.<ref>((cite web |first=Christian |last=Nordqvist |date=February 27, 2013 |title=What Are Fordyce Spots? What Causes Fordyce Spots? |url=http://www.medicalnewstoday.com/articles/256918.php |work=Medical News Today))</ref>

==Prognosis==
Fordyce spots are completely benign<ref name="Scully 2013" /> and require no treatment. They occur in 70 to 80 percent of adults.<ref>((Cite web |title=Fordyce Spots: Symptoms, Causes, Treatment & On Lips |url=https://my.clevelandclinic.org/health/diseases/24140-fordyce-spots |access-date=2024-01-02 |website=Cleveland Clinic |language=en))</ref>

==Epidemiology==
They are present in around 80% of adults.<ref name=DermNet/> They are not usually visible in children, and tend to appear at about age 3, then increasing during puberty and become more obvious in later adulthood.<ref name="Scully 2013" /> They are more prominent in males.<ref name="Scully 2013" />

== References ==
((reflist|2))

((Oral pathology))

[[Category:Penis]]
[[Category:Conditions of the mucous membranes]]
[[Category:Dermal and subcutaneous growths]]
[[Category:Oral mucosal pathology]]
[[Category:Vulva]]

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