Fordyce granules, also known as Fordyce spots, are a common oral and dermatological finding characterized by the presence of ectopic sebaceous glands.
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✅ What Are Fordyce Granules?
Fordyce granules are ectopic sebaceous glands that lack an associated hair follicle. They were first described by John Addison Fordyce in 1896 and are considered a normal anatomical variation rather than a pathological condition.
These granules typically appear as small, yellowish or whitish papules, measuring 1–3 mm in diameter. In the oral cavity, they are most commonly located on:
▪️ Buccal mucosa
▪️ Vermilion border of the lips
▪️ Retromolar area
Their prevalence increases after puberty, likely due to hormonal influence on sebaceous gland activity.
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Fordyce granules are not contagious. They are neither infectious nor associated with viral, bacterial, or fungal agents. Their presence does not indicate a sexually transmitted infection, systemic disease, or poor oral hygiene.
Importantly, they cannot be transmitted through contact, saliva, or sexual activity, a misconception that frequently causes unnecessary anxiety in patients.
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Diagnosis of Fordyce granules is primarily clinical. Key diagnostic features include:
▪️ Asymptomatic presentation
▪️ Bilateral and symmetrical distribution
▪️ Stable size over time
▪️ Absence of erythema, ulceration, or induration
Biopsy is rarely indicated, except in atypical cases or when differentiation from other mucosal lesions is uncertain.
📊 Comparative Table: Differential Diagnosis of Fordyce Granules
| Condition | Key Clinical Features | Diagnostic Considerations |
|---|---|---|
| Fordyce granules | Yellowish, asymptomatic papules; bilateral distribution | Clinical diagnosis; no treatment required |
| Oral candidiasis | White plaques, may be removable, associated with discomfort | Fungal infection; responds to antifungal therapy |
| Leukoplakia | White patches, potentially premalignant | Requires biopsy for histopathological evaluation |
| Oral lichen planus | White striations or plaques, possible erosive areas | Immune-mediated condition; clinical and histological diagnosis |
Despite their benign nature, Fordyce granules are frequently misinterpreted as pathological lesions, leading to unnecessary referrals or overtreatment. Their resemblance to infectious or premalignant conditions highlights the importance of professional familiarity with their clinical presentation.
From a dental perspective, proper identification prevents misdiagnosis and supports evidence-based decision-making. Current literature consistently classifies Fordyce granules as harmless anatomical variants with no malignant potential.
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▪️ Patient education is essential to reduce anxiety and misconceptions.
▪️ Routine monitoring during dental examinations is sufficient.
▪️ Avoid unnecessary biopsy or treatment unless atypical features are present.
▪️ Referral to oral pathology is recommended only in doubtful or symptomatic cases.
✍️ Conclusion
Fordyce granules are a benign, non-contagious, and common anatomical variation of ectopic sebaceous glands. Accurate clinical recognition and patient reassurance are fundamental components of dental practice. Their identification requires no treatment and carries an excellent prognosis.
📚 References
✔ Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2016). Oral and maxillofacial pathology (4th ed.). Elsevier.
✔ Regezi, J. A., Sciubba, J. J., & Jordan, R. C. K. (2017). Oral pathology: Clinical pathologic correlations (7th ed.). Elsevier.
✔ Scully, C. (2013). Oral and maxillofacial medicine: The basis of diagnosis and treatment (3rd ed.). Churchill Livingstone.
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