Fordyce’s Condition

Definition

It is a skin condition in which a person develops small, yellowish growths, mostly on the lips, in the mouth, tongue, cheeks, female labia, and the penis. You may sometimes find it on the lower lip as well, even though it is rare. They are sometimes confused with basal cell carcinoma. Sebaceous hyperplasia appears as small yellow bumps up to 3 mm in diameter. It generally does not interfere in love making as they are painless. They are present in 80-95% of adults.

They are probably present at birth but become bigger and more visible from about puberty onwards. They may occur as a solitary lesion or more frequently in crops of about 50-100.

Causes

The cause is unknown. These problems tend to run in families. A decrease in circulating androgen results in a change in the rate sebocytes migrate from their points of differentiation into the sebaceous unit may be a cause.

Symptoms

Fordyce Condition is a variant of Sebaceous Hyperplasia. Fordyce Disease is characterized by dry, darkened patches of skin in the underarm, pubic, and nipple areas of the body, with raised patches of dried out blisters. Tiny yellow dots in groups and sometimes in sheets on the lips, inside the mouth, and sometimes on the genital skin may be seen.

The disease can cause loss or breakage of hair follicles in these areas. The disorder almost solely affects women after puberty and around the time of menstruation. It becomes trapped in the sweat gland and in the surrounding area causing intense itching, inflammation, and enlargement of the glands. Skin in the area may become darkened and dry; raised patches develop. Hair follicles in the area dry out resulting in loss or breakage of hair.

Treatment

Fordyce’s are usually not biopsied because they are readily diagnosed clinically, but they are often seen as incidental findings of mucosal biopsies of the buccal, labial and retromolar mucosa. The granules are similar to normal sebaceous glands of the skin but lack hair follicles and almost always lack a ductal communication with the surface. The glands are located just beneath the overlying epithelium and often produce a local elevation of the epithelium. Individual sebaceous cells are large, with central dark nuclei and abundant foamy cytoplasm. The surrounding stroma may contain occasional chronic inflammatory cells because of trauma with adjacent teeth.

Fordyce glands are often left untreated, since the condition generally does not pose a health risk. If they affect a patient's appearance and their removal is desired, there are several options, both chemical and physical.

Laser treatments such as CO2 laser or electro desiccation have been used with some success in diminishing the appearance of this condition if they are of cosmetic concern. However, most doctors consider this a normal physiological phenomenon and advise against treatment.