Case Report of Focal Epithelial Hyperplasia (Heck's Disease) with Polymerase Chain Reaction Detection of Human Papillomavirus 13.

Focal epithelial hyperplasia (FEH), or Heck's disease, is an uncommon benign proliferation of oral mucosa caused by the human papillomavirus (HPV), particularly subtypes 13 and 32. The disease typically presents in young Native American patients and is characterized by multiple asymptomatic papules and nodules on the oral mucosa, lips, tongue, and gingiva. The factors that determine susceptibility to FEH are unknown, but the ethnic and geographic distribution of FEH suggests that genetic predisposition, particularly having the human lymphocytic antigen DR4 type, may be involved in pathogenesis. We report a case of FEH with polymerase chain reaction detection of HPV13 in a healthy 11-year-old Hispanic girl and discuss the current understanding of disease pathogenesis, susceptibility, and treatment.

Oral focal fibrous hyperplasia and squamous cell papilloma treated with an erbium laser. Case presentation.

Mouth and oropharynx cancer constitute 5% of all malignancies; 95% of them are head and neck squamous cell carcinomas. Carcinogenesis is a multifactor process. Mutagenesis is also determined by the human papilloma virus which has recently been found to be etiologically associated with 20 to 25% of head and neck squamous cell carcinomas, mostly in the oropharinx. Focal fibrous hyperplasia of the connective tissue comes up as an answer to a chronic irritation in which a big amount of collagen can be found. As there exist certain clinical resemblance between squamous cell papilloma, fibrous focal hyperplasia and other mesenchimal tumors it is recommended to proceed, always, with removal and study. Two cases, one of an oral papilloma and another of a focal fibrous hyperplasia in pediatric patients, treated with an Er,Cr:YSGG laser wave length (mu) of 2780 nm are presented.

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)

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.

Focal epithelial hyperplasia is increasingly frequently observed in rural South African communities. HIV-seropositive subjects have a higher prevalence of oral human papillomavirus (HPV) infections than immunocompetent subjects; and paradoxically, the introduction of highly active antiretroviral therapy for treatment of HIV-seropositive subjects is associated with increased frequency of focal epithelial hyperplasia. We describe a case of focal epithelial hyperplasia in an HIV-seropositive child receiving highly active antiretroviral therapy, who was successfully treated by using diode laser ablation.

Extensive focal epithelial hyperplasia.

Heck's disease or focal epithelial hyperplasia is a benign contagious disease caused by human papillomavirus types 13 or 32. It occurs with low frequency in the Iranian population. This condition is characterized by the occurrence of multiple, small papules or nodules in the oral cavity, especially on the labial and buccal mucosa and tongue. In some populations, up to 39% of children are affected. Conservative surgical excision of lesions may be performed for diagnostic or aesthetic purposes. The risk of recurrence after this therapy is minimal, and there seems to be no malignant transformation potential. In the present work, we presented the clinical case of a 12-year-old Iranian girl with oral lesions that clinically and histologically correspond to Heck's disease.

[Focal epithelial hyperplasia of the oral mucosa. A unique manifestation of human papillomavirus]. / Focale epitheliale hyperplasie van het mondslijmvlies. Een unieke manifestatie van het humaanpapillomavirus.

A 34-year old Creole woman appeared at the dermatology department with white-pink spots on the oral mucosa, which had been there for some time. Histology showed lesions characteristic of focal epithelial hyperplasia. The patient was treated with a CO2 laser. Focal epithelial hyperplasia is a rare benign lesion and is caused by human papillomavirus subtypes 13 or 32; it only appears on the oral mucosa.

Hiperplasia epitelial multifocal: estudio en un grupo de niños indígenas venezolanos / Multifocal epithelial hyperplasia in a group of Venezuelan indigenous children

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.

Hiperplasia nodular focal. Presentación de un caso pediátrico y revisión de la literatura

Los tumores hepáticos primarios representan menos del 2 porciento de las neoplasias en la infancia La hiperplasia Nodular Focal junto con el adenoma hepático representan menos del 4 porciento de los tumores del hígado. Se presenta una niña de 6 meses con esta enfermedad y se revisan en la literatura los aspectos etiopatogénicos y terapéuticos de la misma