Laser Excision of Focal Epithelial Hyperplasia (Heck\'s Disease): A Rare Case Report

Abstract

Heck's disease or focal epithelial hyperplasia is a rare, benign and asymptomatic lesion of oral mucosa that is characterized by the presence of soft, sessile papules, white to pinkish in colour that occur diffusely in oral cavity. Prevalence rate of this disease greatly varies from one geographic region to another. It is found to be closely associated with human papilloma virus (HPV). This paper reports an Indian case of focal epithelial hyperplasia in a 5-year-old boy that is diagnosed according to both clinical and histopathological features, where human poillomavirus (HPV) subtype 32 was found associated with disease through polymerase chain reaction analyses. A dental practitioner should be aware of this disease and must perform a careful evaluation both clinically and histopathologically for setting the diagnosis with other diseases. How to cite this article Nallanchakrava S, Sreebala N, Basavaraj, Sindgi F. Laser Excision of Focal Epithelial Hyperplasia (Heck's Disease): A Rare Case Report. Int J Clin Pediatr Dent, 2018;11(6):526-528

HPV32‐related Heck’s disease in a chronic graft‐versus‐host disease patient with long‐term successful KTP laser treatment: A rare case report

“…Thus, delivery of laser energy at or near absorption peaks for oxyhemoglobin may be an effective means to selectively ablate highly vascular tissues. A similar hemostatic laser was reported to be effective in a pediatric case of FEH 12 …”

“…A similar hemostatic laser was reported to be effective in a pediatric case of FEH. 12 For our patient, one course of 532 nm potassium titanyl phosphate (KTP) laser therapy in the clinic under topical anesthesia was completed (Figure 5B). No adverse effects were noted.…”

A severe manifestation of extensive multifocal epithelial hyperplasia (Heck's disease) and the role of CO2 laser as a treatment modality: A case report

“…MEH is a rare contagious oral condition; thus, strict infection control instructions must be followed during examining and treating patients with these cases. 1 Clinically, the disease manifests as several asymptomatic papules and nodules have whitish or identical colour to the adjacent mucosa. 4 Small discrete lesions, measuring 3-10 mm, coalesce to give the characteristic cobblestone appearance.…”

“…Multifocal epithelial hyperplasia (MEH) or Heck's disease is an uncommon asymptomatic oral condition, characterized by benign proliferation of oral mucosa, which is usually attributed to human papillomavirus infection, especially the non-oncogenic subtypes 13 and 32. [1][2][3] The disease manifests as several smooth papules and nodules, which have whitish or identical colour to the adjacent mucosa. 4 Children and young adults are the most affected age groups, and the majority of the published reports in the literature have been among females.…”

Focal Epithelial Hyperplasia

“…In cases where the lesions grow to a size or at a location where treatment is warranted [ 15 , 16 ], treatment modalities include imiquimoid 5% cream [ 4 , 13 , 34 ], local cryotherapy using liquid nitrogen application [ 6 ], cauterization [ 10 ], surgical resection [ 29 ], ablative laser treatment [ 7 , 12 , 15 , 34 ], laser excision [ 48 ] and 80% trichloroacetic acid [ 49 ]. In a single report describing recurrence, imiquimod treatment was restarted, and the lesions consequently disappeared [ 4 ].…”