Focal epithelial hyperplasia in Sweden

Area of Science:

• Oral Pathology
• Dermatology
• Epidemiology

Background:

• Focal epithelial hyperplasia (FEH), also known as Heck's disease, is a benign epithelial hyperplasia of the oral mucosa.
• Previous studies have indicated a low prevalence, but comprehensive epidemiological data, especially in adult populations, is limited.
• Understanding the prevalence and ultrastructural characteristics is crucial for accurate diagnosis and management.

Purpose of the Study:

• To determine the prevalence of focal epithelial hyperplasia (FEH) in a large adult Swedish population.
• To investigate demographic variations (age, sex) and anatomical distribution of FEH.
• To examine the ultrastructural features of FEH cells and search for evidence of viral particles.

Main Methods:

• Epidemiological survey of 20,333 adult Swedes to identify FEH prevalence.
• Analysis of routine biopsy data from 15,132 patients for FEH frequency.
• Ultrastructural examination of four FEH cells using electron microscopy.

Main Results:

• A prevalence of 0.11% for FEH was observed in the general adult Swedish population.
• FEH was most common on the tongue and in individuals aged over 45 years, with no significant sex predilection.
• Biopsy data showed a higher frequency of 0.26%. Ultrastructural analysis revealed clear cytoplasm, tonofilament condensation, chromatin clumping, and desmosome fragments, but no viral particles.

Conclusions:

• Focal epithelial hyperplasia (FEH) is a relatively uncommon condition in adult Swedes, with a higher prevalence noted in routine biopsies.
• Age and location (tongue) are significant factors in FEH occurrence.
• Ultrastructural findings support cellular changes characteristic of hyperplasia but do not identify a viral etiology in this study.