ABSTRACT
Introdução: a hiperplasia epitelial focal (HEF) ou doença de Heck, caracteriza-se por ser uma lesão benigna rara da mucosa bucal. Geralmente, está associada a proliferação do epitélio pavimentoso atribuída principalmente ao papiloma vírus humano (HPV) dos subtipos 13 e 32. Objetivo: relatar o caso de um paciente, com suspeita diagnóstica de HEF, descrever suas manifestações clínicas bucais e histopatológicas. Metodologia: homem, 38 anos, melanoderma, compareceu no Serviço Universitário com queixa de ardência em mucosa bucal. Ao exame clínico, apresentava múltiplas lesões papulares, firmes à palpação, de coloração rósea, com pápulas aglomeradas ou isoladas, localizadas em rebordo alveolares, gengiva inserida e livre da arcada superior e inferior, mucosas jugais e labiais, compatíveis com lesões causadas por HPV. Realizou-se biópsia incisional das lesões bucais, o laudo histopatológico descreveu o fragmento de mucosa bucal que estava revestida por epitélio pavimentoso estratificado paraceratinizado com acantose proeminente, projeções focais confluentes para o tecido conjuntivo, confirmando a suspeita diagnóstica clínica. Conclusão: a HEF é uma patologia rara, benigna da mucosa, indolor e que pode se resolver espontaneamente. Portanto, é necessário o diagnóstico adequado através da biopsia e laudo histopatológico.
Introduction: focal epithelial hyperplasia (FEH) or Heck's disease is characterized as a rare benign lesion of the oral mucosa. It is usually associated with proliferation of the squamous epithelium, mainly attributed to human papillomavirus (HPV) subtypes 13 and 32. Objective: to report the case of a patient with a diagnostic suspicion of HEF, to describe its oral clinical and histopathological manifestations. Methodology: hale, 38 years old, black, attended the University Service with a complaint of burning in the oral mucosa. On clinical examination, she presented multiple papular lesions, firm to palpation, pink in color, with agglomerated or isolated papules, located in the alveolar ridge, inserted gingiva free from the upper and lower arch, jugal and labial mucosa, compatible with lesions caused by HPV. An incisional biopsy of the oral lesions was performed, the histopathological report described the fragment of oral mucosa that was lined with parakeratinized stratified squamous epithelium with prominent acanthosis, focal projections confluent to the connective tissue, confirming the clinical diagnostic suspicion. Conclusion: FEH is a rare, benign mucosal pathology, painless and can resolve spontaneously. Therefore, proper diagnosis through biopsy and histopathological report is necessary.
Subject(s)
Humans , Male , Adult , Focal Epithelial Hyperplasia/diagnosis , Papillomavirus Infections/diagnosis , Biopsy , Focal Epithelial Hyperplasia/virologyABSTRACT
La hiperplasia epitelial focal (HEF) o enfermedad de Heck es una patolog¡a poco frecuente de la mucosa oral, caracterizada por una proliferaci¢n benigna del epitelio debida a la infecci¢n por el papilomavirus humano (PVH) tipos 13 y 32. El nombre enfermedad de Heck deriva del nombre del mdico que evalu¢ al primer paciente, en Mxico, en 1961. Sin embargo, una revisi¢n de la literatura latinoamericana revela publicaciones previas realizadas por Estrada, en 1956, quien observ¢ esta entidad en indios colombianos. Algunos a¤os despus, Soneira y Fonseca realizaron la primera descripci¢n completa de la enfermedad, y se¤alaron sus caracter¡sticas cl¡nicas e histol¢gicas y, adem s, sugirieron el posible origen viral. Finalmente, en 1965, Archard y col. la denominaron HEF, aunque en la actualidad se sugiere utilizar el nombre de hiperplasia multifocal del epitelio, que describe mejor las caracter¡sticas cl¡nicas y microsc¢picas de la enfermedad. La HEF, aunque.
The focal epithelial hyperplasia (HEF) or Heck's disease is a rare disease of the oral mucosa, characterized by benign epithelial proliferation due to infection with human papillomavirus (HPV) ttypes 13 and 32. The disease name derives Heck the name of the doctor who evaluated the first patient in Mexico in 1961. However, a review of Latin American literature reveals previous publications by Estrada, in 1956, who observed this entity in Colombian Indians. Some years later, Soneira and Fonseca made the first complete description of the disease, noting their clinical and histological features and also suggested the possible viral origin. Finally in 1965, Archard et al. HEF called it, although at present it is suggested to use the name multifocal epithelial hyperplasia, which best describes the clinical and microscopic features of the disease. The HEF is presented with a clear predominance of Americans, Eskimos and Indians some communities in South Africa, although isolated cases in other ethnic groups. In South America it is more common in the Amazon basin of Peru, Venezuela, Colombia, Bolivia, Brazil and Paraguay.
Subject(s)
Focal Epithelial Hyperplasia , Focal Epithelial Hyperplasia/diagnosis , Focal Epithelial Hyperplasia/etiology , Focal Epithelial Hyperplasia/pathology , Focal Epithelial Hyperplasia/therapyABSTRACT
La hiperplasia epitelial multifocal es una enfermedad benigna que se caracteriza por la presencia de múltiples pápulas en la mucosa de la cavidad bucal, asociada con el virus del papiloma humano 13 y 32. En el presente trabajo se describen tres casos con características clínicas similares, donde se evidencian múltiples pápulas no dolorosas localizadas en mucosa bucal y lengua, mostrando un curso lento y benigno las cuales no habían sido diagnosticadas previamente por dentistas de práctica general. Se llevó a cabo el diagnóstico basado en las características clínicas patognomónicas de las lesiones, historia familiar y evolución; se les dio información a los pacientes acerca de su padecimiento y se mantienen periódicamente en observación. El objetivo de este trabajo es mostrar las características clínicas de la hiperplasia epitelial multifocal y hacer una revisión de la literatura en cuanto a la etiología de las lesiones su evolución, diagnóstico diferencial y tratamiento.
Multifocal epithelial hyperplasia is a benign disease characterized by the presence of multiple papules in oral cavity mucosa. It is as-sociated with HPV 13 and 32. In this paper, we describe three cases with similar clinical features, involving the presence of multiple painless papules localized in the oral mucosa and on the tongue, and displaying a slow and benign course. The condition had not been previously diagnosed by general dental practitioners. We made our diagnosis based on the pathognomonic clinical features of the lesions, family history, and evolution of the condition. The patients concerned were provided with information about their disease and kept under regular observation. The aim of this article is to describe the clinical features of multifocal epithelial hyperplasia and present a review of the literature on the etiology of the lesions, their evolution, differential diagnosis, and treatment.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Child , Focal Epithelial Hyperplasia/diagnosis , Focal Epithelial Hyperplasia/etiology , Focal Epithelial Hyperplasia/therapy , Papillomavirus Infections/pathology , Schools, Dental , Follow-Up Studies , Focal Epithelial Hyperplasia/pathology , Mexico , Mouth Mucosa/injuries , PrognosisABSTRACT
La Enfermedad de Heck (EH) o Hiperplasia Epitelial Focal (HEF) es una proliferación benigna poco frecuente de la mucosa oral, generalmente asintomática, causada por el Virus Papiloma Humano (VPH), en su mayoría VPH 13 y 32. Afecta principalmente a niños, predominantemente de sexo femenino. En general se resuelve en forma espontánea, pero en algunos casos por su sintomatología o extenso compromiso se requiere de tratamiento. Existen múltiples modalidades terapéuticas, destacando entre ellas el Imiquimod. Describimos el caso de una paciente de ocho años de edad con una EH que presentó buena respuesta al tratamiento con Imiquimod 5 por ciento.
Hecks Disease (HD) or Focal Epithelial Hyperplasia (FEH) is a rare benign proliferation of the oral mucosa, usually asymptomatic, caused by Human Papilloma Virus (HPV), especially HPV 13 and 32. Affects mainly children, predominantly female.FEH generally resolves spontaneously, but some cases, either because of intensity or extension of symptoms may require treatment. There are several therapeutic alternatives, being Imiquimod the most successful. We report the case of a 8-year old with a HD that present good response to treatment with Imiquimod 5 percent.
Subject(s)
Humans , Female , Child , Aminoquinolines/administration & dosage , Focal Epithelial Hyperplasia/diagnosis , Focal Epithelial Hyperplasia/drug therapy , Administration, TopicalABSTRACT
A doença de Heck é uma condição rara, causada pelo HPV 13 e 32, encontrada principalmente em certos grupos étnicos. Este relato descreve um caso de doença de Heck em uma paciente de 13 anos com múltiplas lesões verrucosas localizadas em lábio superior e inferior (AU)
Heck's disease is a rare condition caused by HPV 13 and 32, found especially in certain ethnic groups. Here we report a case of Heck's disease in a 13-year-old female with multiple verrucose lesions in the upper and lower lips (AU)
Subject(s)
Humans , Female , Adolescent , Focal Epithelial Hyperplasia/diagnosis , Focal Epithelial Hyperplasia/pathology , Focal Epithelial Hyperplasia/ethnology , Papillomavirus Infections/diagnosis , Mouth/pathologyABSTRACT
La Hiperplasia Epitelial Multifocal (HEM) es una enfermedad caracterizada por múltiples pápulas en la mucosa bucal. Ha sido reportada en indígenas, así como en grupos de esquimales y su etiología se relaciona a la infección por VPH. Las lesiones afectan principalmente niños y son de carácter autolimitado y benigno. Se realizó un estudio en seis comunidades indígenas pertenecientes a la etnia Pemón en la Gran Sabana Estado Bolívar en Venezuela, con el objetivo de determinar la presencia de HEM, caracterizar dicha enfermedad y finalmente tratarla. 250 niños fueron evaluados clínicamente en un rango de edades entre 3 y 13 años, de los cuales 18 presentaban HEM (7.2 por ciento). La enfermedad se presentó con predilección 2:1 por el sexo femenino en un promedio de 8 años de edad. Las lesiones fueron más frecuentes en los labios, del mismo color de la mucosa, aunque algunas mostraron una superficie blanquecina, posiblemente producto del roce o mordedura. El estudio histopatológico mostró características de HEM en todos los casos, incluyendo características consistentes con infección por VPH. Las lesiones fueron tratadas exitosamente con criocirugía
Multifocal epithelial hyperplasia (MEH) is a disease characterised by multiple papules on the oral mucosal. MEH has been reported in American Indigenous, as well as in Eskimos and its aetiology has been related to HPV infection. Lesions typically appear in children and show a limited and benign course. The present study was carried out in six Venezuelan Indigenous communities of Gran Sabana, Bolivar State. The aim of the study was to determine the presence of MEH, describe it and eventually treat the disease. 250 children were evaluated and 18 showed HEM features (7.2%). A female predilection was observed (2:1) and the mean of age was 8 years old. Lesions were the same colour of the mucosa or slightly whiter, probably due to chewing or trauma. Lips were more frequently affected. All cases showed histopathological characteristics of MEH, including features consistent with HPV infection. Patients were successfully treated by cryosurgery.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Focal Epithelial Hyperplasia/diagnosis , Focal Epithelial Hyperplasia/epidemiology , Focal Epithelial Hyperplasia/pathology , Indians, South American/ethnology , Cryosurgery/methods , Focal Epithelial Hyperplasia/surgery , Papillomaviridae/pathogenicity , Venezuela/epidemiologyABSTRACT
Niña de 10 años de edad, de raza indo-americana, con placas verrugosas orales de siete meses de evolución. El diagnóstico clínico de hiperplasia epitelial focal fue confirmado por microscopía electrónica. Se realiza la descripción de esta patología frecuente en comunidades indígenas de bajo nivel socioeconómico y su diagnóstico diferencial con otras patologías orales clínicamente similares
Subject(s)
Humans , Female , Focal Epithelial Hyperplasia/diagnosis , Dry Ice/therapeutic use , Focal Epithelial Hyperplasia/pathology , Focal Epithelial Hyperplasia/therapyABSTRACT
La patología blanca de la mucosa oral comprende una constelación de enfermedades cuyos cuadros clínicos se asemejan mucho entre sí y se caracterizan por la presentación de una lesión de aspecto blanquesino en la cavidad bucal. Con el fin de remarcar las diferencias entre cada afección, sus diversas evoluciones y pronósticos y alertar sobre aquellas con tendencia cancerígena y pronóstico más ominoso es que se realiza este trabajo. Es también nuestro interés señalar que no debemos olvidar a la cavidad bucal en el examen dermatológico de rutina
Subject(s)
Humans , Candidiasis, Oral/diagnosis , Dyskeratosis Congenita/diagnosis , Fox-Fordyce Disease/diagnosis , Glossitis, Benign Migratory/diagnosis , Leukoplakia, Hairy/diagnosis , Mouth Mucosa/pathology , Nevus/diagnosis , Syphilis/diagnosis , Candidiasis, Oral/pathology , Condylomata Acuminata/diagnosis , Condylomata Acuminata/pathology , Diagnosis, Differential , Focal Epithelial Hyperplasia/diagnosis , Focal Epithelial Hyperplasia/pathology , Fox-Fordyce Disease/pathology , Glossitis, Benign Migratory/pathology , Leukoedema, Oral/diagnosis , Leukoedema, Oral/pathology , Leukoplakia, Hairy/pathology , Leukoplakia, Oral/diagnosis , Leukoplakia, Oral/pathology , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/pathology , Mouth Diseases , Mouth Neoplasms/diagnosis , Mouth Neoplasms/pathology , Papilloma/diagnosis , Papilloma/pathology , Psoriasis/diagnosis , Psoriasis/pathology , Measles/diagnosis , Measles/pathology , Syphilis/pathology , Stomatitis/diagnosis , Stomatitis/etiologyABSTRACT
A mucosa bucal é muito susceptível, devido a sua função e frente a sua localização anatômica, a traumas de variadas naturezas. A prótese dentária muco-suportada, parcial ou total, quando mal adaptada ou frente ao seu uso prolongado e contínuo, pode ser considerada como agente físico irritante dos tecidos bucais, levando-os a uma reação crônica, caracterizada na maioria das vezes, pela formação de processos proliferativos não neoplásicos, como a hiperplasia fibrosa inflamatória e/ou papilomatosa do palato, estando esta última, mais diretamente relacionada aos recursos utilizados para a retenção da prótese, atualmente não mais em uso nos centros mais desenvolvidos