Fordyce’s granules are ectopic sebaceous glands or sebaceous choristomas (normal tissue in an abnormal location) within the oral mucosa. Normally, sebaceous glands are seen within the dermal adnexa, in association with hair follicles; however, Fordyce’s granules do not exhibit any association with hair structures in the oral cavity. This condition is seen in approximately 80 to 90% of the population.
FeaturesFordyce’s granules present as multiple yellowish white or white papules. They are often seen in aggregates or in confluent collections, most commonly on the buccal mucosa (Figure 5-40, A) and vermilion border of the upper lip. Occasionally, these may be seen on the retromolar pad area and the anterior tonsillar pillars. Men usually exhibit more Fordyce’s granules than women exhibit. The granules tend to appear during puberty and increase in number with age. Fordyce’s granules are completely asymptomatic and are often discovered on routine examination. Histologically, they are identical to normal sebaceous glands found in the dermis (see Figure 5-40, B).
Treatment
Usually no treatment is indicated, and since the clinical appearance is virtually diagnostic, no biopsy is usually required. Fordyce’s granules on the vermilion border of the upper lip may require surgical removal for esthetic reasons. Rare cases of pseudocysts and sebaceous cell hyperplasia and adenoma have been reported.