Fordyce Labial Mucosa — ORE Part 1 MCQ

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EasyOral MedicineFordyce Labial MucosaORE Part 1

A patient has multiple 1–2 mm, firm, white-to-yellow papules on the upper labial mucosa. They are asymptomatic, grouped, and have been present for many years without change. What is the most likely diagnosis?

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Correct answer: D — Fordyce granules

The diagnosis is Fordyce granules: benign ectopic sebaceous glands visible through oral mucosa. They characteristically appear as multiple tiny, discrete white-to-yellow papules, often grouped on the lip vermilion or labial/buccal mucosa, and are asymptomatic and longstanding. Verruca vulgaris is usually exophytic and papillomatous rather than a stable cluster of uniform pale granules. Oral lichen planus typically produces reticular white striae, plaques or erosive disease. Leukoplakia is a persistent white plaque rather than multiple small papules. Focal epithelial hyperplasia produces multiple soft, mucosa-coloured papules or nodules, often with a cobblestone appearance, rather than yellow-white sebaceous granules.

Reference: Bhingardeve A, et al. Treatment of Fordyce Spots with CO2 Laser: A Case Series of Three Patients. Journal of Cutaneous and Aesthetic Surgery, 2024. https://pubmed.ncbi.nlm.nih.gov/38736855/