Lesiones papilomatosas orales: hiperplasia epitelial focal / Oral papillomatous lesions: Focal epithelial hyperplasia

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Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data

BACKGROUND: The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. MATERIAL AND METHODS: Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. RESULTS: The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from 'plaque-like' lesions presented hyperkeratosis (p < 0.001) and epithelial dysplasia (p = 0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p = 0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. CONCLUSIONS: The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied

Increased nuclear beta-catenin expression in oral potentially malignant lesions: A marker of epithelial dysplasia

BACKGROUND: Deregulation of beta-catenin is associated with malignant transformation; however, its relationship with potentially malignant and malignant oral processes is not fully understood. The aim of this study was to determine and compare the nuclear beta-catenin expression in oral dysplasia and oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: Cross sectional study. Immunodetection of beta-catenin was performed on 72 samples, with the following distribution: 21 mild dysplasia, 12 moderate dysplasia, severe dysplasia 3, 36 OSCC including 19 well differentiated, 15 moderately differentiated and 2 poorly differentiated. Through microscopic observation the number of positive cells per 1000 epithelial cells was counted. For the statistical analysis, the Kruskal Wallis test was used. RESULTS: Nuclear expression of beta-catenin was observed in all samples with severe and moderate dysplasia, with a median of 267.5, in comparison to mild dysplasia whose median was 103.75. Only 10 samples (27.7%) with OSCC showed nuclear expression, with statistically significant differences between groups (p < 0.05). CONCLUSIONS: Our results are consistent with most of the reports which show increased presence of beta-catenin in severe and moderate dysplasia compared to mild dysplasia; however the expression of nuclear beta-catenin decreased after starting the invasive neoplastic process. This suggests a role for this protein in the progression of dysplasia and early malignant transformation to OSCC. Immunodetection of beta-catenin could be a possible immune marker in the detection of oral displasia

Pseudoepitheliomatous hyperplasia after diode laser oral surgery. An experimental study

BACKGROUND: to examine the process of epithelial reparation in a surgical wound caused by diode laser. MATERIAL AND METHODS: An experimental study with 27 Sprage-Dawley rats was undertaken. The animals were randomly allocated to two experimental groups, whose individuals underwent glossectomy by means of a diode laser at different wattages, and a control group treated using a number 15 scalpel blade. The animals were slaughtered at the 2nd, 7th, and 14th day after glossectomy. The specimens were independently studied by two pathologists (blinded for the specimens' group). RESULTS: at the 7th day, re-epithelisation was slightly faster for the control group (conventional scalpel) (p = 0.011). At the 14th day, complete re-epithelization was observed for all groups. The experimental groups displayed a pseudoepitheliomatous hyperplasia. CONCLUSIONS: it is concluded that, considering the limitations of this kind of experimental studies, early re-epithelisation occurs slightly faster when a conventional scalpel is used for incision, although re-epithelisation is completed in two weeks no matter the instrument used. In addition, pseudoepitheliomatous hyperplasia is a potential event after oral mucosa surgery with diode laser. Knowledge about this phenomenon (not previously described) may prevent diagnostic mistakes and inadequate treatment approaches, particularly when dealing with potentially malignant oral lesions

Clinical features and histological description of tongue lesions in a large Northern Italian population

BACKGROUND: Only few studies on tongue lesions considered sizable populations, and contemporary literature does not provide a valid report regarding the epidemiology of tongue lesions within the Italian population. In this report, the histopathological and clinical appearance of 1.106 tongue lesions from northern Italians are described and discussed. MATERIAL AND METHODS: The case records of patients referred for the diagnosis and management of tongue lesions, from October 1993 to October 2013, were reviewed. Histological data were also obtained and blindly re-examined. RESULTS: For instance, a biopsy performed on a lingual ulcer has a strong predicting association with a carcinoma, whereas a biopsy on a white lesion predicts for a leukoplakia or oral lichen planus. Moreover, a biopsy of erosion is representative of bullous diseases, whereas a biopsy on a verrucous-papillary lesion is significant for fibroma. Furthermore, carcinomas occur in the majority of cases on the lingual edge or pelvis, oral lichen planus is mainly seen on the edge, and fibromas mostly on the lingual tip. CONCLUSIONS: The high frequency of tongue involvement of such different diseases emphasizes the importance of histological characterization and that some diseases occur more frequently than others, with a peculiar clinical aspect and a more common area. In fact our survey can help the clinician in advancing diagnostic hypothesis, on the basis of the elementary lesion and its site of involvement

Expresión de calretinina en el tumor de células granulares: análisis del gradiente de intensidad en la inmunotinción con correlación clínico-patológica / Calretinin expression in granular cell tumour: an analysis of the immunostaining intensity gradient and its clinicopathological correlation

Introducción. El tumor de células granulares (TCG) es una lesión poco frecuente que aparece predominantemente en mujeres y en el área de cabeza y cuello. Múltiples estudios apuntan a que deriva de las células de Schwann y su perfil inmunohistoquímico ha sido ampliamente estudiado. La expresión de calretinina (CRT) es, sin embargo, la peor caracterizada en el TCG, por ello en este estudio se pretende analizar en detalle su expresión en esta forma tumoral. Material y método. Se analizó una amplia muestra de TCG (n = 43), de los que se recogieron datos clínico-epidemiológicos y se realizó inmunotinción en todos ellos con anticuerpo anti CRT estudiando su patrón de expresión. Resultados. Se encontró que este tumor muestra positividad global frente a CRT en una amplia mayoría de los casos (74%), encontrando un gradiente en la inmunotinción en el 53% de los TCG estudiados, situación observada en los tumores con superficies epiteliales en proximidad y que no ocurre cuando estos epitelios se encuentran ausentes o alejados del TCG. Conclusiones. La tinción frente a CRT es útil para el diagnóstico del TCG y se demuestra la existencia de un gradiente en la inmunotinción cuando el TCG se encuentra en la proximidad de epitelios escamosos, sobre todo cuando estos muestran hiperplasia epitelial pseudoepiteliomatosa, lesión a la que frecuentemente se encuentran asociados (AU)

Introduction. Granular cell tumour (GCT) is a rare lesion which predominately affects women and occurs most frequently in the head and neck. Many reports suggest that the tumour cells are probably derived from Schwann cells. The immunohistochemical profile of GCT has been extensively studied, although calretinin expression (CRT) is the least understood. Our aim is to undertake a detailed analysis of its expression in this tumour. Materials and methods. A large sample of GCT (n = 43) was analysed. Clinical-epidemiological data were collected and immunostaining with CRT was performed in all of them with anti-CRT antibody to study its expression pattern. Results. We found that most of the GCT cases were positive to CRT (74%). Furthermore, in 53% of cases, we detected an intensity gradient in the immunostaining in tumour cells with epithelial surfaces in proximity, which does not occur when these epithelia are absent or distant from the GCT. Conclusions. CRT is a useful marker for the diagnosis of GCT. We found the existence of an immunostaining intensity gradient when the tumour is in close proximity to squamous epithelia, especially when these show pseudoepitheliomatous epithelial hyperplasia, which is often associated with GCT (AU)

Fibroma ameloblástico asociado a un odontoma compuesto. La importancia del estudio histopatológico / Ameloblastic fibroma associated with a compound odontoma. Importance of the histopathological study

El fibroma ameloblástico es un tumor odontogénico mixto benigno de rara aparición, que constituye el 2% de todos los tumores odontogénicos, es de crecimiento lento, más común en niños y adultos jóvenes, compuesto por tejido conjuntivo fibroso embrionario y epitelio odontogénico primitivo, se caracteriza por la proliferación de tejido epitelial y mesenquimático. Aparece con más frecuencia en la mandíbula en zona de molares y premolares de pacientes jóvenes sin predilección de sexo, asociándose a veces a un diente incluido. El presente artículo tiene como objetivo describir un caso clínico de un paciente en la segunda década de vida, con aparente anodoncia en el maxilar superior, que se encontraba asintomático y en el cual fue diagnosticado fibroma ameloblástico en maxilar superior, zona de incisivos anteriores, lado izquierdo, se realiza una breve revisión de la literatura y diagnósticos diferenciales, se analizan sus características clínicas e histológicas y la actitud terapéutica a tomar. El tratamiento quirúrgico conservador con extirpación seguida de curetaje parece ser la opción terapéutica más adecuada, y teniendo presente que el porcentaje de recidiva es del 18,3% principalmente debido a escisión incompleta de la lesión, se deben realizar controles radiográficos postoperatorios 6 meses después y cada año por los siguientes 5 años (AU)

The ameloblastic fibroma is a benign mixed, rare odontogenic tumour, which accounts for 2% of all odontogenic tumours. It is slow growing, and more common in children and young adults. It is composed of embryonic fibrous connective tissue and early odontogenic epithelium, and characterised by the proliferation of epithelial and mesenchymal tissue. It appears most frequently in the jaw area of molars and premolars of young patients with no sex predilection, and is sometimes associated with an impacted tooth. This article aims to describe a clinical case of a child in the second decade of life, with apparent anodontia in the maxilla, which was asymptomatic and later diagnosed as an ameloblastic fibroma in the left side maxilla incisors area. A brief review of the literature and differential diagnoses was carried out, including an analysis of its clinical and histological features, and the therapeutic approach to take. Conservative surgical excision followed by curettage seems to be the most appropriate treatment option. It should be noted that the recurrence rate is 18.3%, mainly due to incomplete excision of the lesion. Radiographic controls should be performed six months postoperatively, and every year for the following five years (AU)

Displasia epitelial focal por el uso de un único cepillo dental en la familia / Focal epithelial dysplasia caused by the use of a sole family toothbrush

La hiperplasia epitelial focal es una de las patologías pertenecientes al grupo de infecciones causadas por el Virus del Papiloma Humano (VPH) relacionada con los tipos 13 y 32. Su transmisión es por contacto directo o indirecto con secreciones infectadas, siendo su grupo poblacional predilecto los niños, cuyo riesgo es mayor si presentan en su familia condiciones de salubridad insuficiente y malas prácticas de higiene. El tratamiento depende de la evolución de las lesiones que en la mayoría de los casos se resuelven espontáneamente, por lo que es suficiente con la observación. En caso de manifestaciones más severas se puede utilizar crioterapia, cirugía y acido acético (AU)

Focal epithelial dysplasia is one of the pathologies belonging to the group of infections caused by the Human Papilloma Virus (HPV), related to types 13 and 32. It is transmitted by direct or indirect contact with infected secretions, with its preferred population group being children, whose risk is greater if inadequate health conditions and bad hygiene practices are present in the family. Treatment is dependent on the evolution of lesions, which in the majority of cases remit spontaneously, in which case, observation is sufficient. In more severe cases, cryotherapy, surgery and acetic acid can be used (AU)

The relevance of uniform reporting in oral leukoplakia: Definition, certainty factor and staging based on experience with 275 patients

The aim of the present study was to evaluate the definition of oral leukoplakia, proposed by the WHO in 2005 and taking into account a previously reported classification and staging system, including the use of a Certainty factor of four levels with which the diagnosis of leukoplakia can be established. In the period 1997-2012 a hospital-based population of 275 consecutive patients with a provisional diagnosis of oral leukoplakia has been examined. In only 176 patients of these 275 patients a firm diagnosis of leukoplakia has been established based on strict clinicopathological criteria. The 176 patients have subsequently been staged using a classification and staging system based on size and histopathologic features. For use in epidemiological studies it seems acceptable to accept a diagnosis of leukoplakia based on a single oral examination (Certainty level 1). For studies on management and malignant transformation rate the recommendation is made to include the requirement of histopathologic examination of an incisional or excisional biopsy, representing Certainty level 3 and 4, respectively. This recommendation results in the following definition of oral leukoplakia: “A predominantly white lesion or plaque of questionable behaviour having excluded, clinically and histopathologically, any other definable white disease or disorder”. Furthermore, we recommend the use of strict diagnostic criteria for predominantly white lesions for which a causative factor has been identified, e.g. smokers’ lesion, frictional lesion and dental restoration associated lesion (AU)

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Reproducibility of grading systems in oral epithelial dysplasia

Objective: To assess inter and intra observer variability in grading oral epithelial dysplasia (OED) using Smith and Pindborg grading system, WHO classification system and Brothwell DJ et al. classification system. Study design: In the study 45 histological tissues of dysplasia, 15 each of mild, moderate and severe dysplasia were coded and blindly graded by three observers in three grading systems. Further on the same observers graded 15 slides again of the previous 45 for analyzing the reproducibility in the three grading systems. The individual significance of various indicators of dysplasia among various grades of dysplasia was also assessed. Result: Inter observer agreement was significantly higher in Brothwell system as compared to WHO and Smith and Pindborg system. Intra observer agreement was significantly higher in Smith and Pindborg system, but the predictability and the probability index was distributed over a larger range in this system. Each indicator of dysplasia was also found to be statistically significant (P<0.05) for grading dysplasia. Conclusion: The present study puts forth the inherent intricacies in the grading of oral premalignant lesions (AU)

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Immunohistochemical expression of EGFR in oral leukoplakia: Association with clinicopathological features and cellular proliferation

Objectives: to investigate the immunoexpression of epidermal growth factor receptor (EGFR) in a sample of oral leukoplakias (OL) and to determine the receptor’s association with dysplasia, tobacco consumption, lesion site, and proliferation rate. Although EGFR should be overexpressed in some oral leukoplakias, the factors that may interfere with this expression and the influence of this receptor on epithelial proliferation have yet to be investigated.Study Design: Samples of oral leukoplakias (48) and of normal oral epithelium (10) were immunohistologically examined for expression of EGFR. Immunohistochemistry for Ki-67, and p27 were also performed in leukoplakias. EGFR expression was associated with clinical and pathological features. Results: EGFR was positive in 62.5% of the leukoplakias and 50% of normal oral epithelium. The number of EGFR positive OL located in high-risk sites was significantly higher than EGFR positive OL located in low-risk sites. Most of the p27 negative leukoplakias were EGFR positive, and the p27 index in the parabasal layer was diminished in the presence of dysplasia. Positivity for EGFR was not associated with dysplasia, tobacco exposure, or Ki-67.Conclusion: EGFR is expressed in leukoplakia regardless of dysplasia, but EGFR positivity should be more frequent in lesions sited in areas of high cancer risk. The association between EGFR and p27 may represent an important mechanism in the control of cellular proliferation and malignant progression of oral epithelium and therefore warrants further investigation (AU)

TWIST and p-Akt immunoexpression in normal oral epithelium, oral dysplasia and in oral squamous cell carcinoma

Objectives: The aim of this study was to evaluate the immunoexpression of TWIST and p-Akt proteins in oralleukoplakia (OL) and oral squamous cell carcinoma (OSCC), correlating their expressions with the histological features of the lesions. Study design: Immunohistochemical studies were carried out on 10 normal oral epithelium, 30 OL and 20 OSCC formalin-fixed, paraffin-embedded tissue samples. Immunoperoxidase reactions for TWIST and p-Akt proteins were applied on the specimens and the positivity of the reactions was calculated for 1000 epithelial cells. Results: Kruskal-Wallis and Dunn’s post tests revealed a significant difference in TWIST and p-Akt immune expression among normal oral mucosa, OL and OSCC. In addition, a significant positive correlation was found between TWIST and p-Akt expressions according to the Pearson’s correlation test. Conclusions: The results obtained in the current study suggest that TWIST and p-Akt may participate of the multistep process of oral carcinogenesis since its early stages (AU)

Ácido tricloroacético, una opción terapéutica en la hiperplasia epitelial focal. Presentación de un caso / Trichloroacetic acid, a therapeutic option in the focal epithelial hyperplasia. Presentation of a case

La Hiperplasia Epitelial Focal es una patología que se caracteriza por la presencia de múltiples pápulas en la mucosa de la cavidad oral, es de etiología viral, producida por subtipos del papiloma virus humano 13 y 32, normalmente se presenta en niños y adolescentes, rara vez afecta a adultos, las lesiones se encuentran con mayor frecuencia en las mucosas labial, yugal y Iingual. Entre las diferentes alternativas de tratamiento se encuentra la quirúrgica, criocirugía, vitamina A, nitrógeno líquido. El ácido tricloroacético es utilizado en el tratamiento de infecciones con papiloma virus humano como condiloma, papiloma, verrugas vulgares en la mucosa vaginal arrojando buenos resultados presentándose resolución de las lesiones y mucosa vaginal en buen estado. Se reporta caso de paciente femenina de 10 años de edad, remitida al servicio de estomatología y cirugía oral de la universidad de Cartagena por dermatología con diagnostico histopatológico de hiperplasia epitelial sin atipias; al examen clínico se observaron múltiples pápulas en mucosa bucal, color rosado pálido, de consistencia blanda, base sésil, tamaño variables (2-4 mm) de diámetro, asintomáticas y de un años de evolución. Como terapéutica de las lesiones se decide la aplicación de ácido tricloroacético a saturación, observándose resolución de las lesiones con dos topicaciones (AU)

Focal epithelial hyperplasia is a condition that is characterized by the presence of multiple papules on the mucosa of the oral cavity is of viral etiology, caused by human papilloma virus subtypes 13 and 32, usually occurs in children and adolescents rarely affects adults, injuries are more frequently in the labial mucosa, buccal and Iingual. Among the various treatment alternatives is the surgery, cryosurgery, vitamin A, liquid nitrogen. Trichloroacetic acid is used in the treatment of infections with human papilloma virus condyloma, papilloma, warts in the vaginal mucosa vulgares successful resolution of the lesions appearing vaginal mucosa and in good condition. We report the case of female patient, aged 10, sent to the service of dentistry and oral surgery at the University of Cartagena in dermatology with histopathological diagnosis of epithelial hyperplasia without atypia, the clinical examination were multiple papules in the oral mucosa, pale pink of soft consistency, base sessile, variable size (2-4 mm) in diameter, asymptomatic, and one years of evolution. Treatment of injuries such as deciding on the application of trichloroacetic acid to saturation, with resolution of lesions with two topical applications (AU)

Hiperplasia epitelial multifocal: un caso familiar / Multifocal epithelial hyperplasia: a familial case

La hiperplasia epitelial multifocal (HEM) o enfermedad de Heck es una patología de la mucosa oral poco frecuente en nuestro medio. Está producida por el virus del papiloma humano (VPH), asociándose fundamentalmente a los tipos 13 y 32. Se presenta en la infancia (3–18 años) y se describe mayor prevalencia en mujeres y en determinados grupos étnicos (indios americanos y esquimales). Consiste en una proliferación epitelial benigna, asintomática, en forma de múltiples pápulas de 3 a 10mm de color mucosa oral normal. Varón ecuatoriano de 14 años, con lesiones papulosas en mucosa oral de inicio a los 4 años de edad. Su madre, de 32 años, presenta idénticas lesiones. Conclusión: Presentamos dos miembros de una familia ecuatoriana con HEM. Aunque se trata de una patología rara en nuestro medio debemos pensar en esta enfermedad dado el aumento de población inmigrante en España (AU)

Multifocal epithelial hyperplasia (MEH), or Heck disease, is a disease of the oral mucosa rarely seen in Spain. It is caused by the human papillomavirus (HPV), and is mainly associated with types 13 and 32. It appears in childhood (3–18 years) and a higher prevalence is reported in women and certain ethnic groups (American Indians and Eskimos). It consists of a benign, asymptomatic epithelial proliferation in the form of multiple papules of 3–10mm with a normal oral mucosa colour. The case involves an Ecuadorian male of 14 years, with papulous lesions in the oral mucosa with onset at 4 years of age. His 32 year-old mother had identical lesions. Conclusion: We present two members of an ecuadorian family with MEH. Although it is a rare disease in Spain, we must take this disease into account, given the increase in the immigrant population in Spain (AU)

Caso de genitourinario presentado en la Sesión General de Lectura de Casos del XXX Congreso Nacional de la SERAM, A Coruña. Mayo 2010 / No disponible

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Pápulas planas labiales en un adulto joven / Flat Papules on the Lip of a Young Adult

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Multifocal epithelial hyperplasia, a rare oral infection in Asia: Report of twelve cases in Iran

Objectives: Multifocal epithelial hyperplasia (MEH) is benign, asymptomatic oral disease with viral etiology. The frequency of this disease varies widely from one geographic region to another, and can vary, from 0.002 to 35% depending on the population studied.Study design: Here we report the clinicopathological features of twelve cases of MEH referred to Oral Medicine Department of Mashhad Dental School for the first time in Iran. Records of patients with the diagnosis of MEH in our department during 7 years were analyzed and data were extracted. Results: Most of the patients were younger than 20-year-old (66%), and females were predominantly affected(7:12). The mean age of onset was 12.72±10.14 years and the mean duration was 52.54 ± 78.51 months. Patients had multiple, well circumscribed, soft, non tender, flattened papules, with a color similar to the adjacent mucosa,in different areas of the oral cavity but the most affected site was buccal mucosa. Familial history of such lesions was negative in all patients. Only three cases showed spontaneous regression.Conclusion: In spite of rare nature of this disease in Asia, it seems that it is not the case in Khorasan Province,southeast Iran (AU)

Extramedullary hematopoiesis within endothelial papillary hyperplasia (Masson’s pseudoangiosarcoma) of the tongue

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We report the unique association of Masson’s pseudoangiosarcoma (endothelial papillary hyperplasia) and extramedullary hematopoiesis. The lesion was present as a violaceous nodule on the side of the tongue of a 78-year-old man with history of multiple myeloma and long-standing mild anemia. This association between a peculiar form of thrombusorganization and extramedullary hematopoiesis has been reported previously only once, in an infant with a cranial hematoma, and raises interesting pathogenetic questions (AU)

Hiperplasia epitelial focal / Focal epithelial hyperplasia

La hiperplasia epitelial focal es una enfermedad poco frecuente de la mucosa oral producida por el virus del papiloma humano. Aparece una proliferación epitelial benigna de predominio en la mucosa del labio inferior. Se asocia fundamentalmente a los serotipos 13 y 32 y existe un claro predominio racial, en indios americanos y esquimales. Presentamos el caso de una chica de 17 años ecuatoriana, con múltiples lesiones papulosas en labio inferior y superior compatibles clínica e histológicamente con hiperplasia epitelial focal. En el estudio por reacción en cadena de la polimerasa se detectó el virus del papiloma humano serotipo 13

Focal epithelial hyperplasia is a rare disease of the oral mucosa caused by the human papilloma virus (HPV). It appears as a benign epithelial growth, usually in the mucosa of the lower lip. It is mainly associated with HPV serotypes 13 and 32 and there is a clear racial predilection for the disease in Native Americans and Eskimos. We describe the case of a 17-year-old girl from Ecuador with multiple papular lesions in both lips that were clinically and histologically consistent with focal epithelial hyperplasia. Analysis by polymerase chain reaction detected HPV serotype 13

Hiperplasia multifocal del epitelio. Reporte de nueve casos / Multifocal epithelial hyperplasia. Report of nine cases

La hiperplasia multifocal del epitelio (HME) conocida tambiéncomo hiperplasia epitelial focal, enfermedad de Heck ó hiperplasiamultifocal del epitelio por papiloma virus, se caracterizapor la aparición de lesiones múltiples en la mucosa de la cavidadbucal en población pediátrica y se asocia a la presencia del viruspapiloma humano. El objetivo de este estudio fue conocer lascaracterísticas clínico-patológicas de los casos diagnosticadosde esta enfermedad en el Servicio de Dermatología del HospitalManuel Gea González. Se revisaron los archivos de estainstitución y se seleccionaron los casos diagnosticados comoHME. Se encontraron 9 casos. La mayoría de los pacientesfueron menores de 20 años (67%) y del sexo femenino (78%),todos los casos presentaron lesiones múltiples y siempre huboparientes directos con lesiones similares. Los lugares que seafectaron con mayor frecuencia fueron: mucosa bucal, labioinferior, paladar y comisuras. La HME es una condición de lamucosa de la cavidad bucal que solamente necesita tratamientode aquellas lesiones que representan un problema cosmético óaquellas que se traumatizan secundariamente. Las demás remitiránconforme avanza la edad del paciente. Se sugiere usarel nombre de hiperplasia multifocal del epitelio pues describemejor las características clínico-patológicas y microscópicasde la enfermedad

Multifocal epithelial hyperplasia (MEH) is also known as focalepithelial hyperplasia, Heck’s disease or multifocal papillomavirus-induced epithelial hyperplasia. It is characterised by thepresence of multiple lesions in the oral mucosa of children andit has been associated with the presence of the human papillomavirus.The aim of this study was to determine the clinicopathologicalfeatures of the cases diagnosed as MEH in theService of Dermatology of the Hospital Manuel Gea González(SDHMGG). The files of the SDHMGG were reviewed and allcases diagnosed as MEH were retrieved. Nine MEH cases werefound. Most of the patients were 20 year-old or younger (67%)and females were more commonly affected (78%). All patientspresented multiple lesions and always, close relatives with similarlesions were found. Lesions were located most commonly inthe buccal mucosa, lower lip and comissures. MEH is a soft tissueintraoral condition that needs treatment solely of the traumatisedlesions or those with cosmetic problems. Remaining lesions willdisappear with the age of the patients. It is suggested that thisentity should be named multifocal epithelial hyperplasia sincethis name describes better the clinico-pathological and microscopicfeatures of the disease