HECK'S DISEASE OR FOCAL EPITHELIA HYPERPLASIA

By Gary M. White, MD

Heck's Disease or Focal Epithelial Hyperplasia Photographs very kindly provided courtesy of Dr. Nikoo Mozafari.


Heck's disease or multifocal papilloma virus epithelial hyperplasia is the presence of multiple soft papules of the oral mucosa cause by infection by HPV especially 13 and 32. Children are most commonly affected (range 3-18 years of age).

Clinical

Multiple, smooth, pink-white dome-shaped or flat-topped papules, 1-5 mm are seen in the oral mucosa. The lower lip is most typical, but lesions may occur on the buccal mucosa, upper lip, tongue and gingiva. The rest of the skin and mucosa should be examined for signs of verruca.

Treatment

No treatment is needed. Spontaneous resolution may occur over 1-2 years. If needed, individual lesions may be frozen or shave biopsied (e.g for diagnosis). Topical imiquimod every other night has been used and cleared one patient after 16 weeks.

Additional Pictures

Photographs very kindly provided courtesy of Dr. Nikoo Mozafari.
Heck's Disease or Focal Epithelial Hyperplasia

Heck's Disease or Focal Epithelial Hyperplasia

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