Fordyce Granules — ORE Part 1 MCQ

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EasyOral PathologyFordyce GranulesORE Part 1

A 30-year-old man presents with multiple 1–2 mm yellowish papules on the buccal mucosa bilaterally. The lesions are clustered, painless and cannot be wiped away. He is otherwise well. What is the most likely diagnosis?

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Correct answer: B — Fordyce granules

The diagnosis is Fordyce granules. These are ectopic sebaceous glands and typically appear as multiple small, pale yellow papules, often in clusters on the buccal or labial mucosa. Their bilateral distribution, absence of symptoms and non-wipeable surface support this benign anatomical variant. Oral candidiasis is usually a white, wipeable pseudomembrane, often leaving an erythematous surface. Verruca vulgaris and squamous papilloma are usually exophytic, rough-surfaced lesions and are more often solitary or localised. Oral lichen planus characteristically produces reticular white striae, sometimes with erythema or ulceration, rather than yellow papules. The clinical features therefore most strongly support Fordyce granules.

Reference: Wootton C, Saihan E. Fordyce spots. BMJ. 2015;350:h2545. https://pubmed.ncbi.nlm.nih.gov/30693453/