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A 28 year old white man presented to the dermatology clinic because of raised, yellow-white coloured skin lesions on the glans of his penis that had been increasing in number over two years. Repeated attempts had been made to cure the affected areas with topical antimycotic drugs, antibiotics, and virostatic agents.
Macroscopic inspection showed a penile mucosa covered by densely aggregated yellow-white, minute papules (figure ). Lesional swabs to look for colonisation with bacteria, fungi, or viruses were unremarkable.
Questions
1 What is the likely diagnosis?
2 What is the causative pathological mechanism?
3 What treatment would you recommend?
4 Which differential diagnoses have to be considered?
Answers
1 What is the likely diagnosis?
Short answer
Fordyce's spots (also known as Tyson's glands or ectopic sebaceous glands).
Long answer
The figure shows numerous yellow-white sharply circumscribed macules and papules with a diameter of 1 mm or less localised on the mucosa of...