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Pathology of Fordyce's Spots

(Ectopic Sebaceous Glands)

Dr Sampurna Roy MD

Path Quiz Case 83: Case history and images

Diagnosis: Fordyce's Spots (Ectopic Sebaceous Glands)

 

Dermpath- India

 Site created by

Dr Sampurna Roy MD

       

http://www. histopathology-india.net/dermpath. htm

March 2014
Benign sweat gland tumours

Cysts:

Hydrocystoma -Eccrine/Apocrine

Hamartomas:

Eccrine/Apocrine naevus

Eccrine  Angiomatous Hamartoma

Porokeratotic  eccrine ostial naevus

Benign Neoplasms:

Syringo cystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma

Syringoma

Spiradenoma

Cylindroma

Chondroid Syringoma (benign mixed tumour)

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringo fibroadenoma

Malignant sweat gland tumour 

Low grade:

Microcystic adnexal carcinoma

Eccrine epithelioma

Adenoid cystic carcinoma

Mucinous  carcinoma

Primary extramammary Pagetís disease

Intermediate grade:

Porocarcinoma

Digital papillary adenocarcinoma

High grade:

Hidradeno carcinoma

Apocrine adenocarcinoma

Eccrine ductal carcinoma

Spiradenocarcinoma

Malignant cylindroma

Sebaceous tumours

Steatocystoma

Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia

Sebaceoma

Sebaceous  Adenoma

Sebaceous Carcinoma

Ectopic sebaceous glands without attached hair follicle may be present near mucocutaneous junction. 

Clinical presentation:   

The incidence of Fordyce's granules increases from childhood to adulthood, and is slightly higher in men. Presents as tiny yellow papules. 

Site: 

Fordyce's Spots - Present along vermillion border of the lips or on the oral mucosa.

Montgomery's tubercle-  Normal sebaceous glands are distributed along a circle in the periphery of the areola of the breast.

Ectopic sebaceous glands are occasionally found in other sites - 

Example:  Esophagus;  penis;  labia minora ; vagina

Normal sebaceous glands on the vermilion border of the lips and the oral mucosa are common in adults.

Only pathologic sebaceous glands visible through the epithelium should be regarded as Fordyce's granules.

Microscopic features:    

    

Histology shows a single sebaceous gland lesion consisting of single or a group of small but mature sebaceous lobules around small sebaceous duct extending to the surface epithelium.

No associated hair follicles are seen.

Differential diagnosis: Sebaceous hyperplasia (enlarged sebaceous glands with numerous lobules around a centrally located wide duct).

                          

Further reading:

Clinicopathologic Manifestations of Patients with Fordyce's Spots.

Ectopic sebacious glands in the esophageal mucosa.

Ectopic Sebaceous Glands in the Esophagus: Endoscopic Findings over Three Years.

[Ectopic sebaceous glands in the esophagus. Report of three cases].

Ectopic sebaceous glands in the esophagus.

Multiple tiny ectopic sebaceous glands discovered throughout entire esophageal tract.

Ectopic sebaceous gland: a developmental anomaly.

Sebaceous adenoma of oral cavity: report of case and comparative proliferation study with sebaceous gland hyperplasia and Fordyce's granules.Oral Dis 2003;9(6):323-7

Hyperplasia of sebaceous glands (Fordyce's disease) in an oral mucocutaneous graft: 45-year follow-up. Klin Monatsbl Augenheilkd. 1999;214(3):185-7.

Heterotopic sebaceous glands in the esophagus: histopathological and immunohistochemical study of a resected esophagus.Pathol Int. 1999 Apr;49(4):364-8.

Fordyce spots. A little regarded finding in the area of lip pigmentation and mouth mucosa. Laryngorhinootologie. 1995;74(6):390-2.

Areolar sebaceous hyperplasia with a Fordyce's spot-like lesion. J Dermatol. 1994 Jul;21(7):524-6.

Ectopic gingival sebaceous glands presenting as localized periodontitis. J Periodontol. 1990;61(1):58-60.

Fordyce's granules in the oral mucosa of adult Israeli Jews.Community Dent Oral Epidemiol. 1986 Aug;14(4):231-2.

Montgomery's areolar tubercle. A light microscopic study.Arch Pathol Lab Med. 1982;106(2):60-3.

Fordyce's spots: disease, heterotopia or adenoma? Histological and ultrastructural study. J Biol Buccale. 1981 ; 9(2):109-28.  

Fordyce's condition of the buccal mucosa and perimamillary region. Hautarzt. 1971 Jun;22(6):263-4.

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

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