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

Abstract

AbstractHeck's disease or multifocal epithelial hyperplasia (MEH) is an uncommon asymptomatic contagious oral condition, usually attributed to human papillomavirus (HPV) infection. It manifests as several smooth papules and nodules in the oral mucosa. The disease has a good prognosis, as it is spontaneously regressing, but some cases persist and affect the quality of the patient's life, requiring therapeutic intervention. We present an unusual case of extensive multifocal epithelial hyperplasia. To the best of our knowledge, this is the first case to be reported with this severity and widespreadness of the lesions. A 14‐ year‐old girl was referred to the department of oral medicine at the faculty of dental medicine, with a chief complaint of numerous nodules and papules, appeared since she was 6 years old. The diagnosis of Heck's disease was confirmed depending on clinical characteristics, histopathological examination and immunohistochemical (IHC) staining. Human immunodeficiency virus (HIV) antibodies test and enzyme‐linked immunosorbent assay (ELISA) for human papillomavirus Immunoglobulin G (IgG) were performed. Depending on the extensive clinical situation, the decision was made to treat the patient using carbon dioxide (CO2) laser. Heck's disease is a human papillomavirus‐related oral condition. The diagnosis can be confirmed depending on both clinical and histopathological characteristics in addition to immunohistochemical staining. In this case, CO2 laser showed good functional and aesthetic results that reflected positively on the quality of the patient's life.