Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

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:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

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

Marcin Kubiak1,A,B,C,D,F, Paweł Stępień1,A,B,E

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)

  1. March C.J.: Multiple papillary tumours of the labial, buccal and glossal mucous membrane. Dental Cosmos, 1881, 23,165.
  2. Stern E.: Multiple weiche Warzen den Mundschleimaut. Derm. Wschr. 1922, 74, 274.
  3. 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.
  4. 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.
  5. Cohen P.R., Hebert A.A., Adler-Storthz K.: Focal epithelial hyperplasia: Heck disease. Pediatr. Dermatol. 1993, 10, 245–251.
  6. 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.
  7. Bassioukas K., Danielides V., Georgiou I., Photos E., Zagorianakou P., Skevas A.: Oral focal epithelial hyperplasia. Eur. J. Dermatol. 2000, 10, 395–397.
  8. Praetorius-Clausen F.: Geographical aspects of oral focal epithelial hyperplasia. Pathol. Microbiol. 1973, 39, 204–213.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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.
  16. Blyumin M., Khachemoune A.: What is your diagnosis? Focal epithelial hyperplasia. Cutis, 2006, 77, 233–234.
  17. De Waal J., Dreyer N.P.: Oral medicine case book 2. SADJ 2007, 62, 406.
  18. 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.
  19. Praetorius-Clausen F.: HPV-associated diseases of oral mucosa. Clin. Dermatol. 1997, 15, 399–413.
  20. 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.
  21. 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.
  22. 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.
  23. 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.
  24. 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.
  25. 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.
  26. 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.
  27. Lutzner M., Kuffer R., Blanchet-Bardon C., Croissant O.: Different papillomaviruses as the causes of oral warts. Arch. Dermatol. 1982, 118, 393–399.
  28. 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.
  29. 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.
  30. 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.
  31. 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.