Multifocal Epithelial Hyperplasia Confined to the Interdental Papilla of an Adult Chinese Man: a Rare Case Report and Literature Review

Overview

Journal BMC Oral Health

Publisher Biomed Central

Specialty Dentistry

Date 2023 Sep 29

PMID 37773130

Authors

Qianting Wang

Lehan Xu

Xiaojun Li

Mengfei Yu

Qianming Chen

Affiliations

Soon will be listed here.

Abstract

Background: Multifocal epithelial hyperplasia (MEH), or focal epithelial hypertension (FEH), or Heck's disease, is an uncommon, benign oral mucosal disease associated with human papillomavirus infection. It is mostly observed in indigenous populations of the world, and has been rarely reported in China. However, previous research suggested there might be a greater prevalence of MEH in the Chinese population. While predominantly involves the lips, buccal mucosa and tongue, MEH was occasionally reported to affect the hard palate and gingiva as well.

Case Presentation: This paper reports a case of extensive MEH lesions that confined to the interdental papilla of a Chinese male without detection of HPV, and summarizes the published gingiva-involved MEH reports from 1966 until present. The lesions were excised with an Er: YAG laser after scaling and root planning, no recurrence was observed after 6-month follow-up.

Conclusions: The present report illustrates the need for clinicians to be aware of rare presentations of MEH to facilitate a prompt diagnosis and proper management. More reports are encouraged to determine a correct prevalence rate of MEH in China.

Citing Articles

HPV Infections-Classification, Pathogenesis, and Potential New Therapies.

Mlynarczyk-Bonikowska B, Rudnicka L Int J Mol Sci. 2024; 25(14).

PMID: 39062859 PMC: 11277246. DOI: 10.3390/ijms25147616.

References

ARCHARD H, HECK J, STANLEY H . FOCAL EPITHELIAL HYPERPLASIA: AN UNUSUAL ORAL MUCOSAL LESION FOUND IN INDIAN CHILDREN. Oral Surg Oral Med Oral Pathol. 1965; 20:201-12. DOI: 10.1016/0030-4220(65)90192-1. View

Sethi S, Ali A, Ju X, Antonsson A, Logan R, Jamieson L . An update on Heck's disease-a systematic review. J Public Health (Oxf). 2021; 44(2):269-285. DOI: 10.1093/pubmed/fdaa256. View

Said A, Leao J, Fedele S, Porter S . Focal epithelial hyperplasia - an update. J Oral Pathol Med. 2012; 42(6):435-42. DOI: 10.1111/jop.12009. View

Liu N, Li Y, Zhou Y, Zeng X . Focal epithelial hyperplasia (Heck's disease) in two Chinese females. Int J Oral Maxillofac Surg. 2011; 41(8):1001-4. DOI: 10.1016/j.ijom.2011.10.032. View

Betz S . HPV-Related Papillary Lesions of the Oral Mucosa: A Review. Head Neck Pathol. 2019; 13(1):80-90. PMC: 6405797. DOI: 10.1007/s12105-019-01003-7. View

Bendtsen S, Jakobsen K, Fenger Carlander A, Gronhoj C, von Buchwald C . Focal Epithelial Hyperplasia. Viruses. 2021; 13(8). PMC: 8402694. DOI: 10.3390/v13081529. View

Nartey N, Newman M, Nyako E . Focal epithelial hyperplasia: report of six cases from Ghana, West Africa. J Clin Pediatr Dent. 2002; 27(1):63-6. DOI: 10.17796/jcpd.27.1.q3125147j7750067. View

Akyol A, Anadolu R, Anadolu Y, Ekmekci P, Gurgey E, Akay N . Multifocal papillomavirus epithelial hyperplasia: successful treatment with CO2 laser therapy combined with interferon alpha-2b. Int J Dermatol. 2003; 42(9):733-5. DOI: 10.1046/j.1365-4362.2003.01777.x. View

Nguyen J, Allen C, Dodge J, Van Doorslaer K, McBride A, Pavletic S . HPV32-related Heck's disease in a chronic graft-versus-host disease patient with long-term successful KTP laser treatment: A rare case report. Clin Case Rep. 2021; 9(5):e04253. PMC: 8123741. DOI: 10.1002/ccr3.4253. View

10.

Di Spirito F, Pantaleo G, Di Palo M, Amato A, Raimondo A, Amato M . Oral Human Papillomavirus Benign Lesions and HPV-Related Cancer in Healthy Children: A Systematic Review. Cancers (Basel). 2023; 15(4). PMC: 9954073. DOI: 10.3390/cancers15041096. View

11.

van der Waal I, Ten Bruggenkate C, VAN DER KWAST W . Focal epithelial hyperplasia in a child from Surinam. Int J Oral Surg. 1975; 4(4):168-71. DOI: 10.1016/s0300-9785(75)80066-4. View

12.

Starink T, WOERDEMAN M . Focal epithelial hyperplasia of the oral mucosa. Report of two cases from the Netherlands and review of the literature. Br J Dermatol. 1977; 96(4):375-80. DOI: 10.1111/j.1365-2133.1977.tb07131.x. View

13.

LUTZNER M, Kuffer R, Blanchet-Bardon C, CROISSANT O . Different papillomaviruses as the causes of oral warts. Arch Dermatol. 1982; 118(6):393-9. View

14.

MORROW D, Sandhu H, Daley T . Focal epithelial hyperplasia (Heck's disease) with generalized lesions of the gingiva. A case report. J Periodontol. 1993; 64(1):63-5. DOI: 10.1902/jop.1993.64.1.63. View

15.

Martins W, De Lima A, Vieira S . Focal epithelial hyperplasia (Heck's disease): report of a case in a girl of Brazilian Indian descent. Int J Paediatr Dent. 2005; 16(1):65-8. DOI: 10.1111/j.1365-263X.2006.00664.x. View

16.

Bennett L, Hinshaw M . Heck's disease: diagnosis and susceptibility. Pediatr Dermatol. 2009; 26(1):87-9. DOI: 10.1111/j.1525-1470.2008.00830.x. View

17.

Prabhat M, Lakshmi C, Madhavi N, Bhavana S, Sarat G, Ramamohan K . Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity. Case Rep Dent. 2014; 2013:871306. PMC: 3884697. DOI: 10.1155/2013/871306. View

18.

Park M, Cho Y, Kim S, Myoung H, Lee J, Lee S . Focal epithelial hyperplasia arising after delivery of metal-ceramic fixed dental prosthesis. J Adv Prosthodont. 2015; 6(6):555-8. PMC: 4279056. DOI: 10.4047/jap.2014.6.6.555. View

19.

Agnew C, Alexander S, Prabhu N . Multifocal Epithelial Hyperplasia. J Dent Child (Chic). 2017; 84(1):47-49. View

20.

Turco M, Magnaterra E, Bisanzi S, Cannistra S, Paganini I, Sani C . Heck's disease: a diagnostic challenge. Int J Dermatol. 2022; 62(3):e184-e186. DOI: 10.1111/ijd.16430. View