Sebaceous glands ectopes D23.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 23.04.2021

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Synonym(s)

Ectopes Sebaceous glands; Ectopic sebaceous glands; Fordyce granules; Fordyce spots; Fordyce state; Free sebaceous glands; Heterotopic sebaceous glands; sebaceous glands free; Sebaceous glands heterotopic

History
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Fordyce, 1896

Definition
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Not bound to hair follicles, "independent" sebaceous glands in the area of the semi-mucosal membranes.

Occurrence/Epidemiology
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Epidemiological data are available for the ectopic sebaceous glands of the red lip. According to studies they occur in 20% of 5-10 year olds, 30% of 18-24 year olds and 55% of 35-45 year olds. They occur less frequently in atopic than in nonatopic people.

Etiopathogenesis
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These are sebaceous gland complexes without hair follicles. They can be idiopathically dislocated but also occur in the context of exfoliative inflammation (e.g. in Stevens-Johnson syndrome). Occasionally eruptive ectopic sebaceous glands are observed in colon cancer (Lynch syndrome) (De Felice C et al. 2005). They have also been described in connection with Muir-Torre syndrome (Ponti G et al. 2015).

Localization
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V.a. localized at the edge of the labial red, anal funnel, glans penis ( Tyson glands), large labia and eyelids.

Not infrequently, ectopic sebaceous glands are also found in the esophagus.

The Montgomery g lands, which are arranged circularly in the areolae mammae, are erroneously included among the ectopic sebaceous glands because of their clinical aspect, since histologically they have glands comparable to an accessory nipple.

Clinical features
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Harmless, mostly multiple, up to 0.1 cm large, isolated but also aggregated to smaller beds, completely symptom-free, yellow to yellow-white, mostly hardly, occasionally also granularly palpable, reactionless nodules. On the lips the sebaceous glands are very often found in the skin-near area of the lip red, on the commissures and on the inside. Puberty seems to stimulate their appearance. Patients should be convinced of the harmlessness of the findings (see rare exceptions).

Histology
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Subepithelial, mature and differentiated sebaceous gland lobules connected to the epithelium of the ceiling by a rudimentary follicular infundibulum.

Differential diagnosis
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Therapy
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Not necessary, if cosmetically noticeably disturbing, treatment with laser (e.g. Erbium-YAG-Laser or CO2-Laser).

Literature
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  1. De Felice C et al (2005) Fordyce granules and hereditary non-polyposis colorectal cancer syndrome. Good 54:1279-1282
  2. Fordyce JA (1896) A peculiar affection of the mucous membrane of the lips and the oral cavity. Journal of Cutaneous and Genitourinary Diseases (Chicago) 14: 413-419Pit-Pagola Pet al. (2011) Ectopic sebaceous glands in the esophagus. Report of three cases. Gastroenterol Hepatol 34:75-78
  3. Massmanian A et al (1995) Fordyce spots on the glands penis. Br J Dermatol 133: 498-500
  4. Moosbrugger EA et al (2011) Disseminated eruption of ectopic sebaceous glands following Stevens-Johnson syndrome. J Am Acad Dermatol 65:446-448
  5. Ocampo-Candiani J et al (2003) Treatment of Fordyce spots with CO2 laser. Dermatol Surgery 29: 869-871
  6. Ponti G et al (2015) Fordyce granules and hyperplastic mucosal sebaceous glands as distinctivestigmata
    in Muir-Torre syndrome patients: characterization with reflectanceconfocal
    microscopy. J Oral Pathol Med 44:552-557.

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Last updated on: 23.04.2021