A 24-Year-Old Male with Papules in His Mouth

Differential Diagnosis

• Sebaceous hyperplasia
• Fordyce spots
• Rubeola
• Oral candidiasis

Diagnosis

This patient was diagnosed with Fordyce spots—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.

Learnings/What to Look for

• Fordyce granules are usually multiple and clustered, and are often found on the oral mucosa and the vermilion of the lips
• Fordyce granules are also often present on the genitalia. They are not associated with hair follicles
• The tiny papules can appear at any point in life but the incidence increases with age, probably associated with hormonal influences

 

Pearls for Urgent Care Management and Considerations for Transfer

• The lesions are asymptomatic. They can be present for years and the patient is usually unaware of their presence. No treatment is required

Acknowledgment: Image and case courtesy of VisualDx (www.VisualDx.com/JUCM).