Multifocal Epithelial Hyperplasia: Persistence in Adulthood and Treatment-A Case Report

Multifocal epithelial hyperplasia (MEH) is a rare, benign epithelial pathology associated with the human papillomavirus (HPV) infection, affecting the oral mucosa. It is primarily observed in children, particularly those from indigenous populations of Latin American origin and typically resolves during adolescence. However, this case report presents a patient with persistent lesions into adulthood. Despite pharmacological treatment, no significant improvements were observed.

A 55-year-old female patient of indigenous descent presented with multiple asymptomatic papillomatous lesions of varying sizes, which had been present since the age of 12. There were no systemic comorbidities. The presence of multiple lesions and the patient's age, differential diagnoses such as Cowden syndrome and oral papillomatosis were considered and subsequently ruled out following clinical evaluation. Histopathological analysis confirmed the initial findings, establishing a definite diagnosis of MEH. The patient underwent combined surgical and pharmacological treatment, involving the application of 80% trichloroacetic acid and 5% imiquimod.

Few case reports of MEH in adult patients exist, and none have thoroughly evaluated the effectiveness of pharmacological treatments. This case underscores the inconsistency of pharmacological therapies in adults, as most studies have focused predominantly on pediatric populations. Therefore, further investigation into alternative pharmacological approaches is warranted for the management of MEH in adult patients.