PDF: Oral focal epithelial hyperplasia: report of five cases

Focal epithelial hyperplasia (FEH) or Heck's disease is a rare contagious disease caused by human papillomavirus that was first described in 1965 from the observation of isolated or multiple soft papular and nodular eruptions on the oral mucosa of Navajo Xavante Indian and Alaska Eskimo children.

Focal epithelial hyperplasia was initially reported mostly among Native Americans, Eskimos and South Africans but has also been found in other ethnic groups. 

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It is more frequent in younger age groups and sometimes has also a characteristic familial occurrence, which led to the suggestion that a genetic predisposition may contribute to the development of the disease.

FEH manifests on the mucosa as multiple or unique soft papules of whitish or normal color with a smooth surface and measuring 1 to 10 mm in diameter. The lesions are painless, tend to disappear spontaneously, and are predominantly found on the lower lip, buccal mucosa and tongue, and less often on the upper lip, gingiva and palate.

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