Multifocal epithelial hyperplasia, a rare oral infection in Asia: Report of twelve cases in Iran

Abstract

Objectives: Multifocal epithelial hyperplasia (MEH) is benign, asymptomatic oral disease with viral etiology. The frequency of this disease varies widely from one geographic region to another, and can vary, from 0.002 to 35% depending on the population studied. Study design: Here we report the clinicopathological features of twelve cases of MEH referred to Oral Medicine Department of Mashhad Dental School for the first time in Iran. Records of patients with the diagnosis of MEH in our department during 7 years were analyzed and data were extracted. Results: Most of the patients were younger than 20-year-old (66%), and females were predominantly affected (7:12). The mean age of onset was 12.72±10.14 years and the mean duration was 52.54 ± 78.51 months. Patients had multiple, well circumscribed, soft, non tender, flattened papules, with a color similar to the adjacent mucosa, in different areas of the oral cavity but the most affected site was buccal mucosa. Familial history of such lesions was negative in all patients. Only three cases showed spontaneous regression. Conclusion: In spite of rare nature of this disease in Asia, it seems that it is not the case in Khorasan Province, southeast Iran.

Focal epithelial hyperplasia (Heck's disease) in two Chinese females

“…FEH is characterised by multiple, asymptomatic, soft, small raised papules or nodules on the oral mucosa. The lesions are predominantly found on the lips, buccal mucosa and tongue 8 . Histological findings include focal epithelial hyperplasia, widened and elongated rete ridges and occasional perinuclear vacuoles.…”

“…Human papilloma virus (HPV) types 13 and 32 are strongly implicated in the aetiology of FEH 8 . The occurrence of FEH varies from 0.002% to 35% depending on the population studied and the geographic region.…”

Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review)

“…It has mainly been observed among isolated groups of native Indians in North, Central and South America and in other very small population groups in Europe and Africa (6)(7)(8)(9)(10)(11)(12)(13).…”

Focal epithelial hyperplasia in a Brazilian family

“…The focal epithelial hyperplasia (FEH) or Heck's disease is a benign and relatively rare condition associated with human papillomavirus (HPV) subtype 13 or 32 [1][2][3][4][5][6][7] . It was initially reported in literature in 1965 by Archard, Heck and Stanley, who observed oral mucosa lesions in American Indian children.…”

“…In some populations up to 40% of children are affected 2,6 . It is clinically characterized by multiple, soft circumscribed nodule elevations or small raised papules on the oral mucosa that often coalesce [1][2][3][5][6][7][8] . The lesions are asymptomatic and may be found by routine examination.…”