Fordyce Granules Recognition — ORE Part 1 MCQ

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EasyOral PathologyFordyce Granules RecognitionORE Part 1

A patient presents with multiple 1–3 mm yellowish papules on the buccal mucosa bilaterally. They are painless, non-scrapable and have been unchanged for several years. What is the most likely diagnosis?

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Correct answer: B — Fordyce granules

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as E

A is correct. Fordyce granules are ectopic sebaceous glands and typically appear as multiple asymptomatic yellowish papules, commonly on the buccal mucosa. Their bilateral, longstanding and unchanged appearance supports a normal anatomical variant rather than infection or neoplasia. Pseudomembranous candidiasis produces removable white or cream plaques, often leaving an erythematous surface. Verruca vulgaris is usually a discrete rough or papillary lesion rather than symmetrical yellow papules. Milia are keratin-filled cysts of skin and are not a typical buccal mucosal finding. Heck disease causes multiple soft, mucosa-coloured papules or plaques, rather than characteristic yellow Fordyce granules.

Reference: Müller S. A Guide to Yellow Oral Mucosal Entities: Etiology and Pathology. Head and Neck Pathology. 2019. https://pubmed.ncbi.nlm.nih.gov/30693453/