[Focal epithelial hyperplasia-Heck's disease]

Focal epithelial hyperplasia (FEH), also known as Heck's disease, is a rare, benign condition of the oral mucosa. It is characterized by multiple, soft, skin-colored or whitish papules or flat nodules that occur primarily on the mucosa of the lips, cheeks, and tongue. The prevalence of this condition is particularly high among indigenous populations of Central and South America, leading to some discussion of a genetic predisposition in addition to familial transmission. However, the number of reported cases from all parts of the world is currently increasing, particularly from Europe. FEH occurs primarily in children and adolescents, but older adults are also affected. Infection with human papillomavirus (HPV) types HPV13 or HPV32 has been identified as the cause of FEH. A definitive diagnosis of Heck's disease based on clinical presentation, histology, and HPV genotyping, as well as the differential diagnosis to rule out other oral manifestations allow for a conservative treatment approach, as the causative HPV types do not have oncogenic potential and the lesions often resolve spontaneously.