Photodynamic therapy in focal epithelial hyperplasia.

Focal epithelial hyperplasia (FEH) is an uncommon benign disorder affecting the oral mucosa. It is primarily associated with human papillomavirus (HPV) infection and presents as multiple white or pink soft papules or nodules. Typically, FEH is asymptomatic. Conventional treatment approaches for FEH include topical medication, surgical excision, CO2 laser ablation, cryotherapy, etc., but their efficacy varies. Photodynamic therapy (PDT) is a non-invasive and selective photochemotherapy method widely utilized in clinical practice. By employing specific light wavelengths to activate photosensitizers and induce the generation of reactive oxygen, PDT exerts cytotoxic effects. However, the application of PDT in treating FEH has not been previously documented. In this study, we present a case demonstrating the complete remission of FEH lesions using PDT, with no recurrence observed over a period of 9 months. This compelling outcome suggests that PDT may be a preferred treatment modality for FEH.

Soybean Fermented with Bacillus amyloliquefaciens (Cheonggukjang) Ameliorates Atopic Dermatitis-Like Skin Lesion in Mice by Suppressing Infiltration of Mast Cells and Production of IL-31 Cytokine.

The present study was conducted with the aim to investigate the ameliorative effects of a new soybean product (cheonggukjang) fermented with Bacillus amyloliquefaciens SCGB1 (SFBA) in atopic dermatitis (AD) mouse model. Visual evaluation of AD induction in the mice indicated the remarkable control of SFBA in reducing the pathological severity of AD-like skin lesions reported as the SCORAD score of AD clinical symptoms. The results revealed that SFBA reduced dorsal skin and epidermal thickness to a similar extent with prednisolone. Further analysis revealed the dominance of SFBA in restraining mast cell infiltration in the dermis; immunoglobulin-E expression in serum; and TH2 IL-4 cytokine and itch-related IL-31 cytokine in the mice skin and serum. SFBA also suppressed scratching behaviours in mice induced by compound 48/80. Further histological findings also revealed the alleviation of collagen fiber deposition in dermal skin of the AD mice model. These actions of SFBA were examined to be mediated by its suppression of the phosphorylation activation of key signalling molecules such as NF-kappaB and MAPK responsible for the induction of cytokine production. Thus, SFBA can be considered as a promising functional food for managing clinical, histological and immunological spectra associated with AD.

Use of trichloroacetic acid for management of oral lesions caused by human papillomavirus.

The human papillomavirus (HPV) has an affinity for squamous cells of stratified keratinized epithelium, thus affecting the lower genital, nasal, and oral tracts. In the oral cavity, HPV is associated with pathoses such as the verruca vulgaris (common wart), squamous cell papilloma, condyloma acuminatum (venereal wart), and focal epithelial hyperplasia (Heck disease). Among the treatments available for these lesions are cryotherapy, electrosurgery, surgical removal, laser therapy, and trichloroacetic acid (TCA). The objective of this research was to determine the behavior of HPV-associated oral pathoses treated with TCA. A prospective cohort study was performed in 20 patients who attended a dental consultation at 2 universities in Cartagena, Colombia. Among the patients, 65% were diagnosed as having focal epithelial hyperplasia, 20% as having verrucae vulgares, and 15% as having condylomata acuminata. Application of TCA to HPV-associated oral lesions proved to be a useful nonsurgical alternative treatment, as the resolution of the lesions was achieved atraumatically in a span of 45 days with 3 applications of 30-60 seconds each.

Focal Epithelial Hyperplasia in Adult Patients With HIV Infection: Clearance With Topical Imiquimod.

Case 1 A 41-year-old man with human immunodeficiency virus (HIV) 1 diagnosed 16 years prior to his consultation was referred for an 8-month history of multiple painless lumps in his mouth. He had A2 status (CD4 cell count of 273 cells/mm3 and viral load of 43,000 copies/L) and was taking treatment with lamivudine/zidovudine (combivir) and efavirenz. Physical examination showed multiple small mucosal-colored and lobulated papulonodules located in the palate and lower gingiva and a whitish verrucous plaque on the lower labial mucosa (Figure 1a). The lesions were diagnosed clinically as focal epithelial hyperplasia (FEH) and further confirmed by classical histopathological findings (Figure 1b). He had previously received unspecified treatment; thus, topical 5% imiquimod cream was initiated every night. Mild erosion and ulceration developed in the upper labial mucosa, which were managed with lubrication (petrolatum ointment). After 2 weeks, all of the small lesions disappeared and the largest plaque resolved 1 week later (Figure 1c). A small residual mass in the area of biopsy, suggesting a scar, remained on the lower lip. The area was removed surgically and corresponded to fibrosis histologically, with no evidence of human papillomavirus (HPV) infection. CD4 cell count (694 cells/mm3) and viral load (<40 copies/L) did not show remarkable changes after imiquimod administration. No serious side effects were observed and the patient has remained free of disease after 1 year of follow-up.

Enfermedad de Heck: a propósito de un caso / Heck’s disease: a case report

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.

Heck’s 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.

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)

An uncommon focal epithelial hyperplasia manifestation.

Focal epithelial hyperplasia is a rare, contagious disease associated with infection of the oral mucosa by human papillomavirus types 13 or 32, characterized by multiple soft papules of the same color as the adjacent normal mucosa. It mainly affects the lower lip, buccal mucosa, and tongue. The purpose of this case report was to describe a rare verrucal lesion located in the upper gingiva that was clinically and histologically consistent with focal epithelial hyperplasia.

Treatment of focal epithelial hyperplasia with topical imiquimod: report of three cases.

Focal epithelial hyperplasia (Heck disease) is a rare disorder caused by specific types of HPV. It mainly involves oral mucosa and children are affected more frequently. It may persist for years, producing a significant reduction in quality of life. Several treatment modalities such as surgical excision, laser ablation, cryotherapy, electrocauterization, topical, intralesional, systemic interferon, and systemic retinoic acid have been used with inconsistent results and many side effects. Here we report three children of Turkish origin with focal epithelial hyperplasia successfully treated with imiquimod 5% cream. No serious side effects were observed and recurrence did not occur during the 1-year follow-up period.

Hiperplasia epitetial focal: enfermedad de Heck: nuestra casuística y revisión del tema / Focal epithelial hyperplasia: Heck's disease: our cases and review of the subject

La hiperplasia epitelial focal (HEF) o enfermedad de Heck es una afección poco frecuente de la mucosa oral producida por la asociación entre el virus del papiloma humano (HPV) subtipos 13 y 32 y un factor genético predisponente. Se inicia a edades tempranas, afecta a ambos sexos por igual y tiene preferencia por la población indígena. Clínicamente se caracteriza por múltiples pápulas circunscriptas o nódulos en la cavidad oral (mucosa labial, yugal y lingual), asintomáticas, de evolución variable y malignización extraordinaria. Se comunican ocho casos que fueron vistos en la Sección Estomatología de la División Dermatología de nuestro hospital.

Hiperplasia epitelial focal o enfermedad de Heck / Focal epithelial hyperplasia or Heck disease

La hiperplasia epitelial focal o enfermedad de Heck es un cuadro benigno causado por la infección provocada por determinados subtipos del virus del papiloma humano (VPH). Cursa con lesiones papulosas blanquecinas aplanadas en la mucosa oral, especialmente en los sitios de roce o trauma. Es excepcional en la raza caucásica y muy prevalente en Sudamérica y Centroamérica. Presentamos un caso epidemiológicamente típico de esta enfermedad que, debido a los movimientos migratorios, se verá cada vez con mayor frecuencia en nuestro medio

Focal epithelial hyperplasia or Heck disease is a benign disorder caused by infection by certain subtypes of human papilloma virus (HPV). It presents with flat whitish papules in the oral mucosa, especially where the latter is subjected to abrasion or at the sites of lesions. It is uncommon among Caucasians, but very prevalent in South and Central America. We present an epidemiologically typical case of this disease which, owing to immigration, will be encountered with increasing frequency among our patient population

[Imiquimod for the topical treatment of focal epithelial hyperplasia (Heck disease) in a child]. / Imiquimod-Creme für die topische Behandlung der fokalen epithelialen Hyperplasie (M. Heck) bei einem Kind.

Focal epithelial hyperplasia (FEH) or Heck disease is a rare skin disease caused by human papilloma viruses (HPV). The case of a 9-year old boy is presented to demonstrate the successful treatment of massive FEH with 5% imiquimod cream. Initially, the patient had noticed several separate papules, which spread and developed into multiple peri- and intraoral papillomatous nodules. The lesions were treated with carbon dioxide laser destruction. However, multiple, skin-coloured papillomatous nodules were found on the tongue, buccal mucosa and lips 1.5 years later. Treatment with imiquimod was initiated, because the patient suffered tremendously from the disease. 5% imiquimod cream was applied 3 times per week. Regression of lesions was obvious after 1 month of treatment. Complete clearance was achieved after 2 additional months of treatment and no recurrence was detected over a follow-up period of 5 months. Our case points out the clinical value of imiquimod for the non-traumatic and almost painless therapy of HPV-induced skin diseases in children.

Successful topical treatment of focal epithelial hyperplasia (Heck's disease) with interferon-beta.

We report the successful topical treatment of focal epithelial hyperplasia (Heck's disease) with interferon-beta (Fiblaferon gel). Topical treatment with interferon-beta appears to be an effective, simple, non-invasive, cheap and low-risk alternative to other invasive or surgical therapeutic modalities.

Focal epithelial hyperplasia treated with interferon alpha-2a.

BACKGROUND: Focal epithelial hyperplasia (FEH) is an uncommon benign oral condition that occurs mainly in young individuals of certain racial groups. METHODS: A 21-year-old Caucasian man presented with FEH of the oral mucosa. The patient was treated with interferon alpha-2a three times a week for 14 weeks intramuscularly (a total of 162 million units). RESULTS: At 2 months after the end of therapy, the papular lesions showed partial regression. CONCLUSION: This treatment modality should be used in cases with diffuse focal epithelial hyperplasia.