Differentiating Fordyce Spots from Their Common Simulators Using Ultraviolet-Induced Fluorescence Dermatoscopy-Retrospective Study.

Abstract

Fordyce spots (FS) are heterotopic sebaceous glands affecting mostly oral and genital mucosa, commonly misdiagnosed with sexually transmitted infections. In a single-center retrospective study, we aimed to assess the ultraviolet-induced fluorescencedermatoscopy (UVFD) clues of Fordyce spots and their common clinical simulants: molluscum contagiosum, penile pearly papules, human papillomavirus warts, genital lichen planus, and genital porokeratosis. Analyzed documentation included patients' medical records (1 September-30 October 2022) and photodocumentation, which included clinical images as well as polarized, non-polarized, and UVFD images. Twelve FS patients were included in the study group and fourteen patients in the control group. A novel and seemingly specific UVFD pattern of FS was described: regularly distributed bright dots over yellowish-greenish clods. Even though, in the majority of instances, the diagnosis of FS does not require more than naked eye examination, UVFD is a fast, easy-to-apply, and low-cost modality that can further increase the diagnostic confidence and rule out selected infectious and non-infectious differential diagnoses if added to conventional dermatoscopic diagnosis.