Dichotomous Long-Term Response to Isotretinoin in Two Patients with Fordyce Spots


Address correspondence to David R. Berk, M.D., Division of Dermatology, School of Medicine, Washington University, Campus Box 8123, 4921 Parkview Place, St. Louis, MO 63110, USA, or e-mail: dberk@dom.wustl.edu.


Abstract:  Fordyce spots are benign, enlarged sebaceous glands that commonly present as tiny yellow papules on a variety of body surfaces, including the lips. Although these lesions are asymptomatic, in some patients, they are abundant and conspicuous, leading to concerns regarding their cosmetic appearance. The response of Fordyce spots to isotretinoin therapy is poorly documented in the literature, which contains only one case report of an affected patient treated with a short course of isotretinoin (35 mg/kg in total). Herein, we report dichotomous long-term response to a standard course of isotretinoin in two patients with Fordyce spots of the lips and concomitant acne.