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Year 2017, Volume: 3 Issue: 1, 11 - 16, 01.04.2017

Abstract

Fokal epitelyal hiperplazi (FEH) veya Heck hastalığı, oral mukozanın nadir görülen, asemptomatik bir proliferasyonudur. Genellikle bukkal mukoza, gingiva, dilde veya dudaklarda birden fazla sayıda, çoğu zaman asemptomatik ancak zaman zaman ağrılı ekzofitik papüller veya nodüller olarak görülür. Lezyonlar herhangi bir tedaviye bağlı olarak ya da olmadan aylar ya da yıllar içerisinde düzelebilse de, süresiz olarak devam edebilir ya da sık sık tekrarlanabilirler. Bu lezyonların, oklüzal travmaya maruz kalacağına karar verilirse veya hastada estetik endişelere neden olursa cerrahi olarak çıkarılabilirler. Kliniğimize 35 yaşında bir kadın hasta, dudağı ve bukkal mukozasında birden fazla nodül yakınması ile başvurdu. Ağız içi muayenesinde, sol bukkal mukoza ve alt dudak olmak üzere çoklu, yumuşak, pembe, inflamatuar, ekzofitik, 2-8 mm’lik papüller görüldü. Papüllerden birinin eksizyonel biyopsisinin histopatolojik incelemesi FEH tanısını teyit etti. Teşhis konulmasının ardından oral lezyonlar, diyot lazer kullanılarak seri eksizyonlarla tedavi edildi. 24 aylık takip sonrasında nüks bulgularına rastlanmamıştır. FEH büyük oranda çocukluk ve ergenlik döneminde görülen bir hastalık olmasına rağmen, bu vaka raporunda, erişkin bir kadın hastada teşhis edilen FEH, diode lazer ile tedavi edilip ve izleyen 24 aylık süreçte takibi yapılmıştır

References

  • [1] Archard HO, Heck JW, Stanley HR. Focal Epithelial Hyperplasia: An Unusual Oral Mucosal Lesion Found in Indian Children. Oral Surg Oral Med Oral Pathol. 1965;20:201-12.
  • [2] Liu N, Li Y, Zhou Y, Zeng X. Focal epithelial hyperplasia (Heck’s disease) in two Chinese females. Int J Oral Maxillofac Surg. 2012;41:1001-4.
  • [3] Ozden B, Gunduz K, Gunhan O, Ozden FO. A Case Report of Focal Epithelial Hyperplasia (Heck’s disease) with PCR Detection of Human Papillomavirus. J Maxillofac Oral Surg. 2011;10:357-60.
  • [4] Borborema-Santos CM, Castro MM, Santos PJ, Talhari S, Astolfi-Filho S. Oral focal epithelial hyperplasia: report of five cases. Braz Dent J. 2006;17:79-82.
  • [5] Flaitz CM. Focal epithelial hyperplasia: a multifocal oral human papillomavirus infection. Pediatr Dent. 2000;22:153-4.
  • [6] Pfister H, Hettich I, Runne U, Gissmann L, Chilf GN. Characterization of human papillomavirus type 13 from focal epithelial hyperplasia Heck lesions. J Virol. 1983;47:363-6.
  • [7] Beaudenon S, Praetorius F, Kremsdorf D, Lutzner M, Worsaae N, Pehau-Arnaudet G, et al. A new type of human papillomavirus associated with oral focal epithelial hyperplasia. J Invest Dermatol. 1987;88:130-5.
  • [8] Said AK, Leao JC, Fedele S, Porter SR. Focal epithelial hyperplasia - an update. J Oral Pathol Med. 2013;42:435-42.
  • [9] Dos Santos-Pinto L, Giro EM, Pansani CA, Ferrari J, Massucato EM, Spolidorio LC. An uncommon focal epithelial hyperplasia manifestation. J Dent Child (Chic). 2009;76:233-6.
  • [10] Castro TP, Bussoloti Filho I. Prevalence of human papillomavirus (HPV) in oral cavity and oropharynx. Braz J Otorhinolaryngol. 2006;72:272-82.
  • [11] Gonzalez LV, Gaviria AM, Sanclemente G, Rady P, Tyring SK, Carlos R, et al. Clinical, histopathological and virological findings in patients with focal epithelial hyperplasia from Colombia. Int J Dermatol. 2005;44:274-9.
  • [12] Morrow DJ, Sandhu HS, Daley TD. Focal epithelial hyperplasia (Heck’s disease) with generalized lesions of the gingiva. A case report. J Periodontol. 1993;64:63-5.
  • [13] Ledesma-Montes C, Vega-Memije E, GarcesOrtiz M, Cardiel-Nieves M, JuarezLuna C. Multifocal epithelial hyperplasia. Report of nine cases. Med Oral Patol Oral Cir Bucal. 2005;10:394-401.
  • [14] Terezhalmy GT, Riley CK, Moore WS. Focal epithelial hyperplasia (Heck’s disease). Quintessence Int. 2001;32:664-5.
  • [15] Martins WD, de Lima AA, Vieira S. Focal epithelial hyperplasia (Heck’s disease): report of a case in a girl of Brazilian Indian descent. Int J Paediatr Dent. 2006;16:65-8.
  • [16] Jayasooriya PR, Abeyratne S, Ranasinghe AW, Tilakaratne WM. Focal epithelial q hyperplasia (Heck’s disease): report of two cases with PCR detection of human papillomavirus DNA. Oral Dis. 2004;10:240-3.
  • [17] Cuberos V, Perez J, Lopez CJ, Castro F, Gonzalez LV, Correa LA, et al. Molecular and serological evidence of the epidemiological association of HPV 13 with focal epithelial hyperplasia: a case-control study. J Clin Virol. 2006;37:21-6.
  • [18] Steinhoff M, Metze D, Stockfleth E, Luger TA. Successful topical treatment of focal epithelial hyperplasia (Heck’s disease) with interferon-beta. Br J Dermatol. 2001;144:1067-9.
  • [19] Puriene A, Rimkevicius A, Gaigalas M. Focal zepithelial hyperplasia: Case report. Stomatologija. 2011;13:102-4.
  • [20] Reddy KV, Anusha A, Maloth KN, Sunitha K, Thakur M. Mucocutaneous manifestations of Cowden’s syndrome. Indian Dermatol Online J. 2016;7:512-5.
  • [21] Wright DD, Whitney J. Multiple hamartoma syndrome (Cowden’s syndrome): case report and literature review. Gen Dent. 2006;54:417-9.
  • [22] Pringle GA. The role of human papillomavirus in oral disease. Dent Clin North Am. 2014;58:385-99.
  • [23] Durso BC, Pinto JM, Jorge J, Jr., de Almeida OP. Extensive focal epithelial hyperplasia: case report. J Can Dent Assoc. 2005;71:769-71.

FOCAL EPITHELIAL HYPERPLASIA (HECK’S DISEASE) TREATED WITH USING A DIODE LASER

Year 2017, Volume: 3 Issue: 1, 11 - 16, 01.04.2017

Abstract

Focal epithelial hyperplasia (FEH) or Heck’s disease is an uncommon asymptomatic proliferation of oral mucosa. It usually presents with multiple asymptomatic and occasionally painful exophytic papules or nodules on the buccal mucosa, gingiva, tongue or lips. Although the lesions may resolve after months or years with or without any specific treatment, they may also indefinitely persist or frequently recur. These lesions can be surgically removed if the lesions are exposed to occlusal trauma or the patient has aesthetic concerns. A 35-year-old female patient was admitted to our clinic with the complaint of multiple nodules on her lip and buccal mucosa. After an intraoral examination, we detected multiple, soft, pink, non-inflammatory, and exophytic 2 to 8 mm papules on the oral mucosa including buccal mucosa and lower lip. Histopathologic examination of the incisional biopsy of a papule confirmed the diagnosis of focal epithelial hyperplasia. Oral lesions were treated with serial partial excisions using diode laser. After 24 months of a follow-up period, there were no signs of recurrence. Although Heck’s disease is generally seen in childhood and adolescence, a rare case of FEH seen in a female adult patient who has got treatment with diode laser and 24 months of follow-up

References

  • [1] Archard HO, Heck JW, Stanley HR. Focal Epithelial Hyperplasia: An Unusual Oral Mucosal Lesion Found in Indian Children. Oral Surg Oral Med Oral Pathol. 1965;20:201-12.
  • [2] Liu N, Li Y, Zhou Y, Zeng X. Focal epithelial hyperplasia (Heck’s disease) in two Chinese females. Int J Oral Maxillofac Surg. 2012;41:1001-4.
  • [3] Ozden B, Gunduz K, Gunhan O, Ozden FO. A Case Report of Focal Epithelial Hyperplasia (Heck’s disease) with PCR Detection of Human Papillomavirus. J Maxillofac Oral Surg. 2011;10:357-60.
  • [4] Borborema-Santos CM, Castro MM, Santos PJ, Talhari S, Astolfi-Filho S. Oral focal epithelial hyperplasia: report of five cases. Braz Dent J. 2006;17:79-82.
  • [5] Flaitz CM. Focal epithelial hyperplasia: a multifocal oral human papillomavirus infection. Pediatr Dent. 2000;22:153-4.
  • [6] Pfister H, Hettich I, Runne U, Gissmann L, Chilf GN. Characterization of human papillomavirus type 13 from focal epithelial hyperplasia Heck lesions. J Virol. 1983;47:363-6.
  • [7] Beaudenon S, Praetorius F, Kremsdorf D, Lutzner M, Worsaae N, Pehau-Arnaudet G, et al. A new type of human papillomavirus associated with oral focal epithelial hyperplasia. J Invest Dermatol. 1987;88:130-5.
  • [8] Said AK, Leao JC, Fedele S, Porter SR. Focal epithelial hyperplasia - an update. J Oral Pathol Med. 2013;42:435-42.
  • [9] Dos Santos-Pinto L, Giro EM, Pansani CA, Ferrari J, Massucato EM, Spolidorio LC. An uncommon focal epithelial hyperplasia manifestation. J Dent Child (Chic). 2009;76:233-6.
  • [10] Castro TP, Bussoloti Filho I. Prevalence of human papillomavirus (HPV) in oral cavity and oropharynx. Braz J Otorhinolaryngol. 2006;72:272-82.
  • [11] Gonzalez LV, Gaviria AM, Sanclemente G, Rady P, Tyring SK, Carlos R, et al. Clinical, histopathological and virological findings in patients with focal epithelial hyperplasia from Colombia. Int J Dermatol. 2005;44:274-9.
  • [12] Morrow DJ, Sandhu HS, Daley TD. Focal epithelial hyperplasia (Heck’s disease) with generalized lesions of the gingiva. A case report. J Periodontol. 1993;64:63-5.
  • [13] Ledesma-Montes C, Vega-Memije E, GarcesOrtiz M, Cardiel-Nieves M, JuarezLuna C. Multifocal epithelial hyperplasia. Report of nine cases. Med Oral Patol Oral Cir Bucal. 2005;10:394-401.
  • [14] Terezhalmy GT, Riley CK, Moore WS. Focal epithelial hyperplasia (Heck’s disease). Quintessence Int. 2001;32:664-5.
  • [15] Martins WD, de Lima AA, Vieira S. Focal epithelial hyperplasia (Heck’s disease): report of a case in a girl of Brazilian Indian descent. Int J Paediatr Dent. 2006;16:65-8.
  • [16] Jayasooriya PR, Abeyratne S, Ranasinghe AW, Tilakaratne WM. Focal epithelial q hyperplasia (Heck’s disease): report of two cases with PCR detection of human papillomavirus DNA. Oral Dis. 2004;10:240-3.
  • [17] Cuberos V, Perez J, Lopez CJ, Castro F, Gonzalez LV, Correa LA, et al. Molecular and serological evidence of the epidemiological association of HPV 13 with focal epithelial hyperplasia: a case-control study. J Clin Virol. 2006;37:21-6.
  • [18] Steinhoff M, Metze D, Stockfleth E, Luger TA. Successful topical treatment of focal epithelial hyperplasia (Heck’s disease) with interferon-beta. Br J Dermatol. 2001;144:1067-9.
  • [19] Puriene A, Rimkevicius A, Gaigalas M. Focal zepithelial hyperplasia: Case report. Stomatologija. 2011;13:102-4.
  • [20] Reddy KV, Anusha A, Maloth KN, Sunitha K, Thakur M. Mucocutaneous manifestations of Cowden’s syndrome. Indian Dermatol Online J. 2016;7:512-5.
  • [21] Wright DD, Whitney J. Multiple hamartoma syndrome (Cowden’s syndrome): case report and literature review. Gen Dent. 2006;54:417-9.
  • [22] Pringle GA. The role of human papillomavirus in oral disease. Dent Clin North Am. 2014;58:385-99.
  • [23] Durso BC, Pinto JM, Jorge J, Jr., de Almeida OP. Extensive focal epithelial hyperplasia: case report. J Can Dent Assoc. 2005;71:769-71.
There are 23 citations in total.

Details

Other ID JA88GF53ZJ
Journal Section Research Article
Authors

Murat Özle This is me

Sercan Küçükkurt This is me

Gizem Dimililer This is me

Burcu Senguven This is me

Sedat Çetiner This is me

Human Papillomavirus Hpv This is me

Publication Date April 1, 2017
Submission Date April 1, 2017
Published in Issue Year 2017 Volume: 3 Issue: 1

Cite

Vancouver Özle M, Küçükkurt S, Dimililer G, Senguven B, Çetiner S, Hpv HP. FOCAL EPITHELIAL HYPERPLASIA (HECK’S DISEASE) TREATED WITH USING A DIODE LASER. Aydin Dental Journal. 2017;3(1):11-6.

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