Sunday, August 4, 2019

Fordyce granules.. Healthy tissues are in place of their natural place. A collection of fatty glands in different places of the mouth. Small yellow spots or combined with oral mucosal level



Fordyce granules:
- Ectopic lesion is a healthy tissue in a place that is not normal. (Teratoma is considered a lesion of Ectopiclesion).
- A collection of fatty glands in different places of the mouth.
- Small yellow spots or combined with oral mucous level or slightly elevated.
- The most common places are the mucosa vestibular in the area of ​​the womb or on the inner surface of the lip or on the triangle behind the mill.
- Sometimes you see these granules on the tongue or palate and may also exist outside the mouth; in the esophagus, cervix and others ...
- Microscopic: Vesicles of the sebaceous glands accumulate under the skin where they are connected directly or through the channels can be filled with free keratin and may not connect with the skin.
- Treatment: Do not need treatment.

Fordyce granules are asymptomatic sebaceous glands commonly found in the oral mucosa, upper lip, and retromolar region. They are characterized by multiple yellowish or whitish papules of 0.1 to 1 mm in diameter that may occasionally coalesce and form plaques.
Only sebaceous glands visible through the epithelium should be considered as Fordyce granules. In children, they are usually not noticed until puberty, although they are histologically present.
Its incidence increases with age, especially after the hormonal stimulus of puberty.
The prevalence in adults is high, with a slight predominance in males.
Histopathologically, the lesions are indistinguishable from the sebaceous glands, but are not associated with the hair follicle and its duct opens directly on the surface.
They are named after the American dermatologist, John Addison Fordyce.

Treatment:
It is an entity with easy clinical diagnosis and no additional exams are required.
It should be distinguished from other oral cavity lesions: small colonies of Candida albicans, tiny lipomas, Koplik patches, viral warts, Cowden Syndrome mucous papular lesions, lichen planus, and leukoplakia.
Despite their asymptomatic character and are considered variants of normality, some patients seek treatment for aesthetic reasons.
There are case reports using bichloroacetic acid, CO2 laser, photodynamic therapy using 5-aminolevulinic acid [6], oral isotretinoin and electrocoagulation curettage.
Fordyce granules have been poorly studied in the dermatological literature.
They are considered a normal variation of the sebaceous glands and of interest for the aesthetic aspect that afflicts some patients.
Some alternatives have been tried for their resolution.
A report of treatment with 5-ALA photodynamic therapy showed poor results with significant side effects such as post-inflammatory pain, erythema, edema, vesiculation, and hyperpigmentation.
Monk treated one patient with oral isotretinoin for cystic acne, with regression of Fordyce granules and recurrence after nine weeks.
Another report cites the use of bichloroacetic acid in the upper lip of a patient with Fordyce granules that showed resolving efficacy for at least three months.
The use of electrodissection and curettage was a therapeutic option in another case.
The CO2 laser has a wavelength of 10,600 nm located in the far infrared region.
It has been used for more than thirty years in surgical dermatology for its efficiency in vaporizing, cutting tissues and producing effective intraoperative hemostasis.
Today's ultra-pulsed systems allow control of tissue warming and precise ablation.
This laser is applied with good response in the treatment of various benign skin lesions and is therefore the therapeutic option in specialized clinics.
The treatment outcome is considered consistent, as obtained by Ocampo-Candiani, who used the CO2 laser in two patients.
Considering the ease of use and the precision with which the lesions are removed, the CO2 laser is credited as a great alternative for treating Fordyce granules.
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Fordyce pimples are small yellowish or whitish spots, which can arise on the lips, inside the cheeks or on the genitals, which arise naturally and have no health consequences.
These grains are sebaceous glands that increase in size and, therefore, can arise at any age, being more frequent at puberty due to hormonal changes. It is not related to HIV, herpes, sexually transmitted diseases, genital warts or cancer.
Although Fordyce grains do not need to be treated, there are some treatments that can eliminate them for aesthetic reasons, through the use of creams or even laser surgery.

What causes the appearance of grains:
Fordyce grains are normally present from birth, however, it may not be observed. After adolescence, due to hormonal alterations during this phase, these grains can be enlarged by becoming visible.
Fordyce grains can arise in anyone, including women, but they are twice as common in men and in people with very oily skin.

Are Fordyce granules contagious?
Fordyce grains are not contagious and are not caused by infectious agents such as bacteria or viruses. These arise naturally in the region of the mouth and genitals, causing only aesthetic problems and not health.

Main symptoms:
The symptoms of Fordyce pimples are the appearance of small yellow or whitish spots, isolated or grouped, in the mouth or genital region.
Fordyce pimples in the mouth usually appear on the upper lip, on the inside of the cheek or on the gums. In the genital region, mainly in men, the appearance of Fordyce granules in the body of the penis, glans, foreskin or testicles is common.
Fordyce granules do not cause pain or irritation, only altering the aesthetics of the region where they arise. In the presence of any of these signs or symptoms, you can go to the dermatologist to diagnose the disease and discuss the available treatment options.

How the treatment is performed:
The treatment of Fordyce grains is done just for aesthetic reasons and injuries are not always completely eliminated. Some of the most common options are:
- Use of ointments and creams with Tretinoin or dichloroacetic acid: eliminate skin disorders, but should only be used under the direction of a dermatologist;
- Micropunction technique: a light anesthesia is applied and then the doctor uses an apparatus to remove the granules from the skin;
- CO2 laser: the doctor uses a powerful beam of light that removes pimples from the skin, however this technique can leave scars and, therefore, should only be done by a dermatologist.
These treatment techniques can be used to eliminate p disguise Fordyce pimples from all parts of the body, including in the genital region.
Some natural remedies such as jojoba oil, vitamin E or argan extract, being used successfully in the treatment of Fordyce grains in association with drug treatments.
In addition to this, it is important to avoid squeezing the beans at home, since this technique does not cause their removal and increases the risk of a skin infection.