Treatment of Focal Epithelial Hyperplasia with Topical Imiquimod: Report of Three Cases

Abstract

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.

Topical imiquimod for the palliative treatment of recurrent oral squamous cell carcinoma

“…Well known side effects of topical imiquimod include erythema, edema, pruritus, and burning, as well as pain, superficial erosions, and ulceration. Topical administration rarely leads to systemic side effects such as fever, headache, and myalgias 6 . In general, imiquimod is a well-tolerated, self-applicable treatment with minimal side effects 7 .…”

Focal epithelial hyperplasia by human papillomavirus (HPV)‐32 misdiagnosed as HPV‐16 and treated with combination of retinoids, imiquimod and quadrivalent HPV vaccine

“…Suggested first-line treatments include surgical excision, cryotherapy, electrocoagulation and laser therapy. 12,13 In all of them, the treatment was well tolerated with none or mild adverse effects (burning sensation, mild headache and herpes labialis), and complete resolution of lesions without recurrences. Topical retinoic acid and imiquimod have been previously described in treatment of HPV-induced mucocutaneous lesions.…”

Focal epithelial hyperplasia in a Brazilian family

“…Differential diagnosis is very important to condylomata acuminata, as it is also caused by HPV, and its isolated lesions are very similar. However, the lesions found in FEH tend to be flatter and more numerous, adding the fact that the location of these lesions in the labial and buccal mucosa are very typical 6,7,22 .…”