Dental and Medical Problems
2015, vol. 52, nr 4, October-December, p. 516–520
doi: 10.17219/dmp/58591
Publication type: clinical case
Language: English
Download citation:
Focal Epithelial Hyperplasia (Heck’s Disease) – Case Report of a Rare Disease in an Adult Caucasian Man
Choroba Hecka – opis przypadku rzadkiej choroby u dorosłego mężczyzny
1 Department of Maxillofacial Surgery, Wroclaw Medical University, Wrocław, Poland
Abstract
Focal epithelial hyperplasia (or Heck’s disease) is an infection of the oral mucosa caused by human papillomavirus. The condition is extremely rare, with the highest incidence in tribal communities from remote Greenland, and North and South America. Only few cases have been noted in adult Caucasian patients. This paper reports on a case of focal epithelial hyperplasia in a 56-year-old man admitted to the Department of Maxillofacial Surgery, Wroclaw Medical University for investigation of multiple mucosal lesions in the oral cavity. The lesions were excised under local anesthesia without any complications. According to the findings of a histopathological examination, the lesions were classed as focal epithelial hyperplasia. The diagnosis was supported by the detection of human papillomavirus subtype 32. Physicians, dentists and other oral medicine specialists should be aware of this kind of lesions and a careful clinical observation combined with histopathological testing should be carried out to establish a definitive diagnosis.
Key words
human papillomavirus, focal epithelial hyperplasia, Heck’s disease
Słowa kluczowe
wirus brodawczaka ludzkiego, ogniskowy przerost nabłonka, choroba Hecka
References (31)
- March C.J.: Multiple papillary tumours of the labial, buccal and glossal mucous membrane. Dental Cosmos, 1881, 23,165.
- Stern E.: Multiple weiche Warzen den Mundschleimaut. Derm. Wschr. 1922, 74, 274.
- Ledesma-Montes C., Garces-Ortiz M., Hernandez-Guerrero J.C.: Clinicopathological and immunocytochemical study of multifocal epithelial hyperplasia. J. Oral Maxillofac. Surg. 2007, 65, 2211–2217.
- Archard H.O., Heck J.W., Stanley H.R.: Focal epithelial hyperplasia: an unusual oral mucosal lesion found in Indian children. Oral Surg. Oral Med. Oral Pathol. 1965, 20, 201–212.
- Cohen P.R., Hebert A.A., Adler-Storthz K.: Focal epithelial hyperplasia: Heck disease. Pediatr. Dermatol. 1993, 10, 245–251.
- Hettwer K.J., Rodgers M.S.: Focal epithelial hyperplasia (Heck’s disease) in a Polynesian. Oral Surg. Oral Med. Oral Pathol. 1966, 22, 466–470.
- Bassioukas K., Danielides V., Georgiou I., Photos E., Zagorianakou P., Skevas A.: Oral focal epithelial hyperplasia. Eur. J. Dermatol. 2000, 10, 395–397.
- Praetorius-Clausen F.: Geographical aspects of oral focal epithelial hyperplasia. Pathol. Microbiol. 1973, 39, 204–213.
- Vera-Iglesias E., Garcia-Arpa M., Sanchez-Caminero P., Romero-Aguilera G., Cortina de la Calle P.: Focal epithelial hyperplasia. Actas Dermosifiliogr. 2007, 98, 621–623.
- Harris A.M.P., van Wyk C.W.: Heck’s disease (focal epithelial hyperplasia): a longitudinal study. Community Dent. Oral Epidemiol. 1993, 21, 82–85.
- Cuberos V., Perez J., Lopez C.J., Castro F., Gonzalez L.V., Correa L.A., Sanclemente G., Gaviria A., Müller M., Sanchez G.I.: Molecular and serological evidence of the epidemiological association of HPV 13 with focal epithelial hyperplasia: a case-control study. J. Clin. Virol. 2006, 1, 21–26.
- Segura-Saint-Gerons R., Toro-Rojas M., Ceballos-Salobrena A., Aparicio-Soria J.L., Fuentes-Vaamonde H.: Focal epithelial hyperplasia. A rare disease in our area. Med. Oral Patol. Oral Cir. Bucal. 2005, 10, 128–131.
- Praetorius-Clausen F.: Rare viral disorders (molluscum contagiosum, localised keratoacanthoma, verrucae, condiloma acuminatum and focal epithelial hyperplasia). Oral Surg. Oral Med. Oral Pathol. 1972, 34, 604–617.
- Henke R.P., Guerin-Revershon I., Milde-Langosch K., Koppang H.S., Loning T.J.: In situ detection of human papillomavirus types 13 and 32 in focal epithelial hyperplasia of the oral mucosa. J. Oral Pathol. Med. 1989, 18, 419–421.
- Jayasooriya P.R., Abeyratne S., Ranasinghe A.W., Tilakaratne W.M.: Focal epithelial hyperplasia (Heck’s disease): report of two cases with PCR detection of human papillomavirus DNA. Oral Dis. 2004, 10, 240–243.
- Blyumin M., Khachemoune A.: What is your diagnosis? Focal epithelial hyperplasia. Cutis, 2006, 77, 233–234.
- De Waal J., Dreyer N.P.: Oral medicine case book 2. SADJ 2007, 62, 406.
- Marvan E., Firth N.: Focal epithelial hyperplasia in an HIV positive man. An illustrated case and review of the literature. Aust. Dent. J. 1998, 43, 305–310.
- Praetorius-Clausen F.: HPV-associated diseases of oral mucosa. Clin. Dermatol. 1997, 15, 399–413.
- Gonzalez L.V., Gaviria A.M., Sanclemente G., Rady P., Tyring S.K., Carlos R., Correa L.A., Sanchez G.I.: Clinical, histopathological and virological findings in patients with focal epithelial hyperplasia from Colombia. Int. J. Dermatol. 2005, 44, 274–279.
- Nartey N.O., Newman M.A., Nyako E.A.: Focal epithelial hyperplasia: report of six cases from Ghana, West Africa. J. Clin. Pediatr. Dent. 2002, 27, 63–66.
- Sawyer D.R., Arole G., Mosadomi A.: Focal epithelial hyperplasia. Report of three cases from Nigeria, West Africa. Oral Surg. Oral Med. Oral Pathol. 1983, 56, 185–189.
- Durso B.C., Pinto J.M.V., Jorge J. Jr, de Almeida O.P.: Extensive focal epithelial hyperplasia: case report. JCDA, 2005, 71, 769–771.
- De Villers E.M., Neumann C., Le J.Y., Weidauer H., zur Hausen H.: Infection of the oral mucosa with defined types of human pipillomaviruses. Med. Microbiol. Immunol. 1986, 174, 287–294.
- Garlick J.A., Calderon S., Buchner A., Mitrani-Rosenbaum S.: Detection of human papillomavirus (HPV) DNA in focal epithelial hyperplasia. J. Oral Pathol. Med. 1989, 18, 172–177.
- Hernandez-Jauregui P., Eriksson A., Tamayo Perez R., Pettersson U., Moreno-Lopez J.: Human papillomavirus type 13 DNA in focal epithelial hyperplasia among Mexicans. Arch. Virol. 1987, 93, 131–137.
- Lutzner M., Kuffer R., Blanchet-Bardon C., Croissant O.: Different papillomaviruses as the causes of oral warts. Arch. Dermatol. 1982, 118, 393–399.
- García-Corona C., Vega-Memije E., Mosqueda-Taylor A., Yamamoto-Furusho J.K., Rodríguez-Carreón A.A., Ruiz-Morales J.A., Salgado N., Granados J.: Association of HLA-DR4 (DRBI*0404) with human papillomavirus infection in patients with focal epithelia hyperplasia. Arch. Dermatol. 2004, 140, 1227–1231.
- Moerman M., Danielides V.G., Nousia C.S., Van Wanzeele F., Forsyth R., Vermeersch H.: Recurrent focal epithelial hyperplasia due to HPV13 in an HIV-positive patient. Dermatol. 2001, 4, 339–341.
- Feller L., Khammissa R.A.G., Wood N.H., Malema V., Meyerov R., Lemmer J.: Focal epithelial hyperplasia (Heck disease) related to highly active antiretroviral therapy in an HIV-seropositive child. A report of a case, and a review of the literature. SADJ 2010, 65, 172–175.
- Park M.W., Cho Y.A., Kim S.M., Myoung H., Lee J.H., Lee S.K.: Focal epithelial hyperplasia arising after delivery of metal-ceramic fixed dental prosthesis. J. Adv. Prosthodont. 2014, 6, 555–558.