A 14-year-old boy presented with gradually increasing, asymptomatic white elevations over the mucosa of right cheek since 4 years of age. There was no history of tobacco abuse, and the past medical history and family history were unremarkable. Examination showed clusters of small white papules with smooth shiny surface on the right cheek (Fig. 1). The lesions could not be scraped off. Rest of the mucocutaneous and systemic examination was normal. The condition was diagnosed as Fordyce spots and the parents were reassured.

Fig. 1 Fordyce spots on mucosa of right cheek.

Fordyce spots are ectopically located visible　sebaceous glands on the genitals, lips and oral cavity, vermillion border of the lips being the commonest site. They appear as small, painless, raised, pale, red or yellow-white spots of 1 to 3　mm diameter. Their presence is considered as normal anatomic variants rather than a true medical condition. They are not usually visible in young children, and tend to appear at about 3 years of age increase during puberty and become more obvious in later adulthood. The condition needs to be differentiated from candidiasis (easily detachable white pseudomembranes), leukoplakia (adherent white plaque often with fissured surface) and white sponge nevus (thick, velvety, white spongy-looking plaques on buccal mucosa). No treatment is required; CO2　laser or electro desiccations may be used to cosmetic concerns.