Heck's disease

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Obesity, Sleep & Internal medicine
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Heck's disease
Synonyms	Focal epithelial hyperplasia
Pronounce	N/A
Specialty	N/A
Symptoms	Multiple small papules on the oral mucosa
Complications	Rarely, dysplasia
Onset	Childhood
Duration	Chronic
Types	N/A
Causes	Human papillomavirus (HPV) types 13 and 32
Risks	Genetic predisposition, immunosuppression
Diagnosis	Clinical examination, biopsy
Differential diagnosis	Oral warts, lichen planus, leukoplakia
Prevention	Good oral hygiene, avoiding risk factors
Treatment	Often self-limiting, cryotherapy, laser therapy
Medication	None specific, topical treatments may be used
Prognosis	Excellent, usually resolves spontaneously
Frequency	Rare
Deaths	N/A

Heck's disease or Focal epithelial hyperplasia is a benign condition of the oral mucosa that was first described by Archard and Heck in 1965. It is characterized by multiple small white to pinkish papules that occur throughout the oral cavity. The condition is caused by the human papillomavirus (HPV), specifically types 13 and 32.

Etiology

The cause of Heck's disease is the human papillomavirus (HPV), specifically types 13 and 32. These types of HPV are not associated with the types that cause cervical cancer or genital warts. The virus is thought to be transmitted through direct contact, either through saliva or skin-to-skin contact.

Clinical Features

Heck's disease presents as multiple small, white to pinkish papules that occur throughout the oral cavity. The lesions are usually asymptomatic and can persist for months to years. The condition is most commonly seen in children and young adults, but can occur at any age. It is more common in certain populations, including Native Americans and Inuits.

Diagnosis

The diagnosis of Heck's disease is typically made based on the clinical appearance of the lesions. A biopsy may be performed to confirm the diagnosis and to rule out other conditions. The histologic features of Heck's disease include acanthosis, parakeratosis, and the presence of mitosoid cells.

Treatment

Treatment for Heck's disease is usually not necessary as the condition is benign and the lesions often resolve on their own. However, if the lesions are causing discomfort or are cosmetically unacceptable, they can be removed by surgical excision, laser ablation, or cryotherapy.

Prognosis

The prognosis for Heck's disease is excellent. The condition is benign and does not lead to cancer. However, the lesions can persist for months to years and may recur after treatment.

See Also

• Oral pathology
• Human papillomavirus

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