Cases Of Focal Epithelial Hyperplasia Research Articles

Molecular biology for hpv typing in focal epithelial hyperplasia

Parichehr Ghalayani and colleagues (Volume 31, Number 1, Pages:060-063) report three interesting cases of focal epithelial hyperplasia (FEH) diagnosed through clinical and microscopic analysis (1). We would like to emphasize that, although the age and ethnicity of the patient may support the clinical suspicion of FEH, the histopathological features of FEH might be similar to that of condyloma acuminatum and oral squamous cell papilloma (2).

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

Focal epithelial hyperplasia, or Heck's disease, is a relatively rare virus-induced benign disease. To the best of the authors’ knowledge it has not been reported in an ethnic Chinese population. The authors report two cases of focal epithelial hyperplasia (FEH) in Chinese patients, which were clinically and histologically in accord with FEH. In particular, the lesions in one case were located on the gingival mucosa, which is rarely affected by FEH. DNA extracted from paraffin-embedded specimens from the two patients was tested for the presence of human papilloma virus followed by specific polymerase chain reaction testing for 16, 18, 13, and 32 subtypes in order to confirm the clinical diagnosis.

A Case Report of Focal Epithelial Hyperplasia (Heck’s disease) with PCR Detection of Human Papillomavirus

Focal epithelial hyperplasia or Heck's disease, is a rare viral infection of the oral mucosa caused by human papillomavirus. The frequency of this disease varies widely from one geographic region to another. In Caucasians there have been only few cases reported. This paper reports a case of focal epithelial hyperplasia and demonstrates the association with HPV subtype 32 through polymerase chain reaction (PCR) and sequencing of PCR products. A 7-year-old Caucasian girl was admitted to our clinic for investigation of multiple oral mucosal lesions in the mouth. Lesion was excised under local anesthesia without any complication. The lesion was diagnosed as focal epithelial hyperplasia according to both clinical and histopathological features. Dental staff should be aware of these kind of lesions and histopathological examination together with a careful clinical observation should be carried out for a definitive diagnosis.

Focal Epithelial Hyperplasia Caused by Human Papillomavirus 13

Focal epithelial hyperplasia is a benign, papulo-nodular disease of the oral cavity. It is rare, affecting primarily Native American populations during childhood. It is closely associated with human papillomavirus 13 and 32. This report describes the diagnosis of 2 cases of focal epithelial hyperplasia in children from southern Guyana. The diagnosis was made using clinical criteria, polymerase chain reaction, and DNA sequencing.

Detection of human papilloma virus DNA in seven cases of focal epithelial hyperplasia in Iran

Focal epithelial hyperplasia (FEH), also known as Heck's disease, is a very rare disease of the oral cavity especially in Asia. It is a disease of children and young adults. Various causes have been implicated but in majority of cases FEH is caused by some subtypes of human papilloma virus (HPV) especially 13 and 32. Polymerase chain reaction (PCR) is a useful tool to identify HPV in FEH as it is a rapid and sensitive method. This study was designed to determine special HPV subtypes in seven cases of Heck's disease referring to our department by using PCR analysis. Paraffin sections of seven patients clinically diagnosed as FEH with compatible histhopathological features underwent DNA extraction procedures for PCR examination. Initially, all specimens were tested for presence of HPV virus followed by specific PCR testing for 16, 18, 13, and 32 subtypes in positive samples. Human papilloma virus was found in all samples. In five cases HPV13 and in one case HPV32 was positive. One case showed strong reactivity for HPV but none of tested subtypes were positive. All cases were negative for HPV 16 and 18. Similar with other studies about FEH, most of our cases were associated with HPV 13 but other subtypes may also be implicated.

Heck's Disease: Diagnosis and Susceptibility

Focal epithelial hyperplasia, or Heck's disease, is an uncommon proliferation of oral mucosa that presents primarily in Native Central and South American populations. It presents as asymptomatic papules or nodules on the oral mucosa, gingiva, tongue, and lips. In the majority of cases, human papilloma virus 13 or 32 is detected. Factors that determine disease susceptibility are unclear, but genetics, and having the human lymphocytic antigen-DR4 (DRB1*0404) allele in particular, are thought to play a major role in disease vulnerability. We report another case of focal epithelial hyperplasia, hypothesize on disease susceptibility, and review the current understanding of this uncommon disorder.

Focal epithelial hyperplasia of the oral mucosa

A case of focal epithelial hyperplasia of the oral mucosa (Heck's disease) is presented, which appears to be the first to be described in the United Kingdom. Virus particles were found in tissue from the lesions studied by electron microscopy, and identified as belonging to the papilloma virus sub-group of the family of papovaviruses.

Focal epithelial hyperplasia: report of six cases from Ghana, West Africa.

Focal epithelial hyperplasia is a proliferative growth of the oral mucosa with distinct clinical and histopathological features. Although focal epithelial hyperplasia is frequently reported in children of American Indian and Eskimo descent, it is rarely seen in Africans. This report presents six new cases of focal epithelial hyperplasia observed in African children. The age of the patients ranged from 4 to 12 years, and all except one were females. Clinical variants, the papillary and the papular types were noted in the same patient. There was spontaneous regression of focal epithelial hyperplasia in four patients during the study period. However, the lesions still persist in two patients three years after the initial presentation.

Human papillomavirus (HPV) DNA in focal epithelial hyperplasia by in situ hybridization.

Eighteen cases of focal epithelial hyperplasia (FEH) were investigated for the presence of human papillomavirus (HPV) group specific antigen by immunocytochemistry and HPV types 1, 6, 11, 13, 16, 18 and 32 by DNA in situ hybridization employing biotinylated probes. Seven (39%) specimens demonstrated the presence of HPV group specific antigen. Fifteen (83%) specimens were positive for HPV DNA: 9 (60%) showed HPV 32, of which 6 were on non-keratinized mucosa and 3 on border of keratinized and non-keratinized mucosa; 5 (33%) showed HPV 13, 4 lesions on keratinized mucosa and 1 on non-keratinized mucosa; 1 (7%) specimen on non-keratinized mucosa showed HPV-11 related. Two specimens on different sites from one patient showed the same HPV type and one patient had, in addition to FEH, a squamous papilloma also demonstrating the same HPV type. Results show a specific HPV distribution pattern in the epithelium indicating areas of high viral concentration adjacent to areas of low or no viral concentration. This study also indicates the possibility of tissue-site specificity or a latent infection and the possibility of a yet unidentified HPV type associated with FEH. It is suggested that future monitoring of patients be carried out with special reference to HPV type and anatomical distribution pattern for FEH lesions.

Focal Epithelial Hyperplasia (Heck's Disease): The First Reported Case from Italy

A case of focal epithelial hyperplasia (Heck's disease) of the oral mucosa observed for the first time in Italy is reported. The patient was of Italian extraction. The lesions, represented by soft nodules, were multiple and located on the vestibular and labial mucosa. Biopsy tissues were studied for the presence of human papilloma virus (HPV) by electron microscopy, in situ hybridization and immunoperoxidase staining to HPV group antigens. No viral particles consistent with HPV were found in the epithelial cells. The tissues were positive for HPV antigen by immunoperoxidase staining and hybridized to the HPV 13 probe. In situ hybridization to the HPV 6, HPV 11, HPV 16, HPV 18 and 32 probes was negative. Our study substantiates that focal epithelial hyperplasia, although rare, may be observed in Whites and that HPV 13 in associated with the disease.

In situ detection of human papillomavirus Types 13 and 32 in focal epithelial hyperplasia of the oral mucosa

17 cases of focal epithelial hyperplasia of the oral mucosa (FEH, Heck's disease) were investigated for the presence of human papillomavirus (HPV) nucleic acid sequences by means of in situ DNA hybridization using biotinylated DNA probes of HPV types 1, 6, 11, 13, 16, 18, and 32. Ten of 17 cases were positive for HPV 13 DNA in contrast to 6 of 17 positive cases obtained after application of the HPV 32 probe, with a double infection in one case. The results of our study suggest, that HPV 13 and HPV 32 are very specifically found in lesions of FEH and can be detected in a high percentage of cases using in situ hybridization.

Human papillomavirus type 13 and focal epithelial hyperplasia of the oral mucosa: DNA hybridization on paraffin-embedded specimens.

16 cases of focal epithelial hyperplasia (Heck's disease) were studied for the presence of human papillomavirus DNA by means of nucleic acid hybridization. Hybridization was carried out in situ with biotin-labelled probes of HPV 1, 6, 11, 13, 16, and 18 DNA under stringent and non-stringent conditions. Under non-stringent conditions, 6 of 16 cases (38%) hybridized to a mixture of HPV 1, 6, 11, 16, and 18 DNA. When these probes were applied under stringent conditions, only one case could be shown to be weakly positive for HPV 6/11 DNA. Further stringent hybridizations, which were conducted with a HPV 13 probe on 12 of our 16 cases, revealed a positive result in 9 of 12 cases (75%). The results of our study strongly substantiate the concept that HPV 13 or a closely related HPV type is associated with lesions morphologically presenting as focal epithelial hyperplasia.

Focal epithelial hyperplasia: report of two cases and review of literature

Two cases of focal epithelial hyperplasia were observed in Tehran, Iran. No cases had been reported previously in the literature in Iran. The patients whose cases are presented were both white females. Multiple nodular lesions were seen on the upper and lower labial and buccal mucosa. The lesions were clinically and histologically consistent with focal epithelial hyperplasia (Heck's disease). No further treatment was undertaken as the lesions usually regress spontaneously.

Disturbed expression of ribonucleotide reductase and cytokeratin polypeptides in focal epithelial hyperplasia

Four cases of focal epithelial hyperplasia (FEH) were studied immunohistochemically, using monoclonal antibodies against the M1 subunit of ribonucleotide reductase and different cytokeratin polypeptides. The FEH lesions showed, compared to normal oral mucosa, extensive alterations in their staining patterns. This included ectopic suprabasal M1 staining and the novel expression of cytokeratin polypeptides differing from those previously reported for other HPV infections. The results are discussed in relation to the causative agent, human papillomavirus, and its expression in focal epithelial hyperplasia.

Focal epithelial hyperplasia: Report of nine cases from Sweden and review of the literature

Nine cases of focal epithelial hyperplasia (FEH) from the northern part of Sweden are reported. Four of these occurred within the same Caucasian family. In one case FEH was diagnosed in a Laplander, ethnically related to Eskimos. The results of follow-up after surgical removal of the lesions are presented.

Focal epithelial hyperplasia: Report of three cases from Nigeria, West Africa

The first cases of focal epithelial hyperplasia from Nigeria and West Africa are presented. Although cases of this disease have been reported in Coloureds from South Africa, the three cases in this report represent the first in black Africans. The probability that the etiologic agent is a communicable agent, perhaps a virus, is reinforced by the clinical histories of the two related patients in this report.

Focal Epithelial Hyperplasia

A typical case of focal epithelial hyperplasia in a 56-year-old white female is reported. It is the first case described among the Greek population. Approximately 60 discrete and clustered papules were seen on the patient's lower lip, commissures and buccal mucosa. No evidence of the disease was found in any member of the patient's family. 4 months after the diagnosis, the lesions showed considerable regression.

Focal epithelial hyperplasia of the mouth: recently discovered in South Africa.

Seventy-six cases of focal epithelial hyperplasia are encountered during an epidemiological survey in the Western Cape Province of South Africa. They affected only Cape Coloureds and were confined to pupils of reform schools and residents of a secluded community. This pattern of distribution, coupled with its typical clinical and histological features and the fact that viral particles were observed in lesions, indicates a communicable disease of viral origin, possibly a virus of the papova group. The recent discovery of its presence in South Africa indicates that it may be newly introduced into the country or that it is a new or hitheto undetected manifestation of an existing viral disease.

Focal epithelial hyperplasia in a group of South Africans: Its clinical and microscopic features

Thirty-seven cases of focal epithelial hyperplasia were discovered among pupils of reform schools and none among pupils of ordinary schools. This difference in occurrence was significant (P less than 0.01). Lesions were either discrete papules or clusters of papules; and the lining mucosa was the most affected part. Eighteen cases were examined microscopically revealing the typical features of the condition. The fact that these lesions occurred in a select group of pupils all of whom are classified as Cape Coloured points to either a selective distribution of the disease or a spread of the disease among people living in communal circumstances. This pattern of distribution coupled with the clinical and histological features would fit a disease of viral origin which is also communicable.

Focal epithelial hyperplasia (Heck’s disease): report of case

A case of focal epithelial hyperplasia in a black woman is reported. What is believed to be the first case of focal epithelial hyperplasia in a black is reported. The painless lesions appear on the lips, cheeks, tongue, and palate, and the condition is viewed as a benign change of unknown origin.