de Castro Luciano Alberto, de Castro Joao Gabriel Leite, da Cruz Alexandre Duarte Lopes, Barbosa Bruno Henrique de Sousa, de Spindula-Filho Jose Vieira, Costa Mauricio Barcelos
School of Medicine, Federal University of Tocantins, Palmas-TO, Brazil.
Department of Biological and Biomedical Sciences, Pontifical Catholic University of Goias, Goiania-GO, Brazil.
J Clin Med Res. 2016 Apr;8(4):346-50. doi: 10.14740/jocmr2466w. Epub 2016 Feb 27.
Focal epithelial hyperplasia (FEH), or Heck's disease, is a rare disease of the oral mucosa associated with infection by some subtypes of human papilloma virus, especially subtypes 13 or 32. The disease is predominantly found in children and adolescents with indigenous heritage, but other ethnic groups can be affected worldwide. To the best of the authors' knowledge, it has not been reported in Brazil's elderly population. This article describes a case of FEH in a 57-year-old Brazilian patient presenting since childhood, with multiple lesions in the lips, buccal mucosa and tongue. The solitary tongue lesion underwent excisional biopsy and the histopathological analysis showed parakeratosis, acanthosis, rete pegs with a club-shaped appearance, koilocytosis and the presence of mitosoid cells. These microscopic findings in conjunction with clinical presentation were sufficient to establish the accurate diagnosis of FEH. Polymerase chain reaction (PCR) was performed, but no one human papillomavirus (HPV) subtype could be identified. Clinicians must be aware of this rare oral disease, which can even affect elderly patients, as we described here. Treatment may be indicated in selected cases due to esthetic and/or functional problems.
局灶性上皮增生（FEH），即赫克病，是一种与某些人乳头瘤病毒亚型感染相关的口腔黏膜罕见疾病，尤其是13型或32型。该疾病主要见于有原住民血统的儿童和青少年，但全球其他种族群体也可能受到影响。据作者所知，巴西老年人群中尚未有相关报道。本文描述了一例57岁巴西患者自童年起就出现的FEH病例，其嘴唇、颊黏膜和舌头有多处病变。对舌部的孤立性病变进行了切除活检，组织病理学分析显示有角化不全、棘层肥厚、呈棒状外观的 rete 钉突、凹空细胞以及类有丝分裂细胞的存在。这些微观发现结合临床表现足以确诊FEH。进行了聚合酶链反应（PCR），但未鉴定出任何一种人乳头瘤病毒（HPV）亚型。临床医生必须了解这种罕见的口腔疾病，正如我们在此所描述的，它甚至可能影响老年患者。由于美观和/或功能问题，在某些特定情况下可能需要进行治疗。
