Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
http://www.sciepub.com/author/signin

To unsubscribe from our mailing list, please click on the following link: unsubscribe

I am looking forward to hearing from you.

Kind regards,

David Rain
Email:join@sciepub.com
Science and Education Publishing (http://www.sciepub.com)

Fordyce Granules Associated with Hypopigmentation of Facial Skin

Khurshid A Mattoo*, Manas Singh, Swati Gupta

Department of Prosthodontics, College of dentistry, Jazan University, Jazan, (KSA)

Abstract: Fordyce granules are referred to as benign sebaceous glands, which are ectopic in distribution and are characterized by the multiple light yellow raise papules, occurring mainly in the lip region. Observed mainly in adults, the disease is rarely associated with physiological skin hypopigmentation. This case report describes a case of an elderly patient who presented depigmentation of skin over the face with unilateral Fordyce granules on the left side of the buccal mucosa.

Keywords: sebaceous glands, sebum, crown, macule, papule

Received December 14, 2014; Revised December 23, 2014; Accepted December 30, 2014

Citation: Khurshid A Mattoo, Manas Singh, Swati Gupta, Fordyce Granules Associated with Hypopigmentation of Facial Skin. Oral Surgery Oral Medicine Oral Radiology, 2 (2). 23-24. January 2014. doi:10.12691/oral-2-2-5

1. Introduction

The sebaceous glands are microscopic exocrine (Holocrine) glands in the skin that secrete sebum (fat, tallow), an oily or waxy substance. Their functions include mainly lubrication and diminishing water permeability of surrounding skin, hair, eyelids and areola. Physiologically their function allows delaying dehydration in hot conditions, whereas in colder condition, the sebum produces a lipid coating that repels water. It primarily contains triglycerides, wax esters, Squalene and free fatty acids like sapienic acid, which is unique to humans and is related to the development of acne. [1,2,3,4] Fordyce spots, or Fordyce granules, are ectopic sebaceous glands found on the genitals and oral mucosa. They show themselves as yellowish-white spots (milk spots). [5] Reported first on vermilion border of the lips, oral mucosa, they also have been reported on the genital mucosa (glans penis and labia minor), esophagus, gastroesophageal junction, uterine cervix, sole of the foot, thymus and tongue [6-11].

Clinically they appear as small, painless, raised, pale, red or white spots or bumps about 1 to 3mm in diameter and are not associated with any disease or illness, however certain physiological variations may be present on the skin in other parts of the body. This clinical report is significant for two reasons, one is its rare association with facial hypopigmentation and the second is its unilateral distribution.

2. Case Report

A 52-year-old man was referred from the department of oral medicine to the department of Prosthodontics for consultation regarding restoration of an endodontically treated tooth. Patient’s medical history was non – contributory. Extra oral examination disclosed light brown colored patches diffusely spread over the region of the left forehead (Figure 1A) and left cheek (Figure 1A). The patient reported that the patches were present since birth. Intra oral examination revealed a completely dentulous arch with extensive stains and calculus. Oral mucosal examination showed closely-grouped asymptomatic yellow maculopapules, 1–2 mm in diameter, on the left buccal mucosa, which was clinically consistent with Fordyce granules (Figure 2a). The appearance of the right buccal mucosa and other parts of oral mucosa was normal. The patient did not report any systemic abnormality.

Figure 1. Facial areas of depigmentation (arrow marks) more prominent in (A) the area of lateral surface of the bridge of nose and (B) forehead region

Histopathologically, the observed lesions were multi centric (Figure 2 B) with slightly elevated papules and plaques. Histological picture was that of a normal sebaceous gland and consisted of a single lobule or gland located in the submucosa. The lobule was well formed and consisted of small clusters of mature sebocytes with sebaceous duct.

Figure 2. Fordyce granules present on the (A) left buccal mucosa (B) Histopathology

3. Discussion

Fordyce spots present an ectopic variation of normal sebaceous glands. The difference though is that the glands are otherwise associated with hair follicle, which is not true for Fordyce spots. The ducts in this case open directly onto the mucosa. These lesions affect both sexes, and usually become prevalent after puberty. They may be bilateral and rather symmetrical. Unilateral cases have been less reported. This case presents one such rare occurrence, especially the skin hypopigmentation seen in this case. However, unilateral occurrence has been reportedly associated with facial nerve paralysis [12].

The relation between Fordyce spots and the depigmentation of the skin cannot be established in this case as the skin condition has been present since birth. It is not clear whether this is a coincidence or a true relationship. The patient could not provide the chronological information about the development of Fordyce spots or the skin depigmentation. Referable to the above mentioned reasons biopsy was considered that is usually not the case, because they are readily diagnosed clinically. The condition being asymptomatic in nature, therefore, offers less treatment demands. Treatment may be demanded by the patient for cosmetic reasons since the lesion does not resolve. Carbon dioxide laser and oral isotretinoin or topical trichloracetic acid/bichloracetic acid, 5-aminolevulinic acid – Photodynamic therapy and chemical cauterization are some of the options for such cases [13,14].

4. Conclusion

Unilateral Fordyce spots have been rarely reported and there is no such report of the lesion associated with hypopigmentation of the skin. This article in the form of a case report is a further addition to the possible variations that could be associated with Fordyce spots

References

[1]   | Bohn CL. Fordyce condition; sebaceous gland tumors of the mucosa of the cheeks. Ugeskr Laeger. 1952; 114: 1105-07.
[2]   | Olivier JH. Fordyce granules on the prolabial and oral mucous membranes of a selected population. SADJ.2006; 61: 072-074
[3]   | James WD, Berger TG, Elston DM. Andrew's disease of the skin. Clinical dermatology. 10th Ed. Philadelphia: WB Saunders; 2006: 800.
[4]   | Ahmed TSS, Priore JD, Seykora JT. Tumors of the appendages. In: Elder DE, Elenitsas R, Johnson BL, Murphy GF, editors. Lever's histopathology of the skin. 10th Ed. Philadelphia: Lippincott Williams & Wilkins; 2009. pp. 872-873.
[5]   | Fordyce JA. A peculiar affection of the mucous membrane of the lips and oral cavity. J Cutan Dis. 1896; 14:413-419.
[6]   | Nakada T, Inoue F, Iwasaki M, Nagayama K, Tanaka T. Ectopic sebaceous glands in the esophagus. Am J Gastroenterol. 1995; 90: 501-503
[7]   | Kushima R, Von Hinüber G, Lessel W, Stolte M, Borchard F. Sebaceous gland metaplasia in cardiac-type mucosa of the oesophago-gastric junction. Virchows Arch. 1996; 428: 297-299.
[8]   | Fichera G, Santanocito A. Pilo-sebaceous cystic ectopy of the uterine cervix. Clin Exp Obstet Gynecol. 1989; 16: 21-25.
[9]   | Richfield DF. Sebaceous gland on sole of foot? Arch Dermatol. 1980; 116: 383.
[10]   | Wolff M, Rosai J, Wright DH. Sebaceous glands within the thymus: report of three cases. Hum Pathol. 1984; 15: 341-343.
[11]   | Kovero O. A sebaceous gland in the dorsal surface of the tongue. Int J Oral Maxillofac Surg. 1989; 18:266.
[12]   | Mansur AT and Aydingoz IE. Unilateral buccal Fordyce spots with ipsilateral facial paralysis: A sign of Neuro – sebaceous connection. Acta Dermato Venereologica 2012; 92 (2): 177-178.
[13]   | Baeder FM, Pelino JE, de Almeida ER, Duarte DA, Santos MT. High-power diode laser use on Fordyce granule excision: a case report. J Cosmet Dermatol. 2010: 9: 321-324.
[14]   | Kim YJ, Kang HY, Lee ES, Kim YC. Treatment of Fordyce spots with 5-aminolaevulinic acid-Photodynamic therapy. Br J Dermatol. 2007; 156: 399-400.