Issues‎ > ‎vol1n1‎ > ‎


Focal epithelial hyperplasia in Yemeni families: Three case reports

Salwa M. Al- Shaikhani

Department of Preventive Dentistry, Technical Institute, Presidency of Sulaimani Polytechnic University.



This is the first time to get the opportunity to report and study three cases from three families with focal epithelial hyperplasia (FEH) in Yemen. Clinically they presented as focal and/or diffuse papillomatous lesions in the oral mucosa in children. The purpose of this paper is to add information concerning clinical feature, the possible etiologic factors and diagnosis of this disease which is totally unknown to the general Yemeni medical professionals and to raise dentist’s awareness about these rare conditions.

Keywords: Focal epithelial hyperplasia, human papillomavirus, Hecks disease.


1.      Regezi JA and Sciubba JJ. Oral pathology: clinical pathologic correlations. 3rd ed. 1999. Philadilphia.Sanders Company. p:167

2.      Castro TH, Neto CE, Scala KA, Scala WA. Oral Manifestations related to HPV. Brazilian J Otorhinolaryngology. 2004;70:546 -550. 

3.      Witkop CJ, Niswander JD. Focal epithelial hyperplasia in Central and South American Indians and Ladinos. Oral Surg Oral Med Oral Pathol. 1965;20:213-7.

4.      Archard HO, Heck JW, Stanley HR. Focal epithelial hyperplasia: An unusual oral mucosal lesion found in Indian children. Oral Surg Oral Med Oral Pathol. 1965; 20: 201-12.

5.      Periman A and Uthman A. focal epithelial hyperplasia, report of seven cases from Iraq. Oral Surg Oral Med Oral Pathol. 1971;31:221-5.

6.      El-Khashab MM and Abd-El-Aziz AM. Focal epithelial hyperplasia (Heck's disease) Oral Surg Oral Med Oral Pathol. 1971;31:637-64.

7.      Buchner A. Focal epithelial hyperplasia in an Israeli family of Libyan origin. Oral Surg Oral Med Oral Pathol. 1978;46:64-69.

8.      Alijandro A, Gilberto M. John F.N. Focal epithelial hyperplasia. Oral Surg Oral Med Oral Pathol. 1981;51:524-6.

9.      Ledesma-Montes C, Vega-Memije E, Garcés-Ortíz M, Cardiel-Nieves M, Juárez-Luna C. Multifocal epithelial hyperplasia. Report of nine cases. Med Oral Patol Oral Cir Bucal. 2005;10:394-401.

10.    Omar M, Muhammad A, Randhawa A. Case Report: Oral Focal Epithelial Hyperplasia (Heck’s Disease). JAMC. 2009; Vol. 20, No. 1.

11.    Hashemipour MA, Shoryabi A, Adhami S, Mehrabizadeh Honarmand H. Extensive focal epithelial hyperplasia. Arch Iran Med.


12.    VanWyk CW.Focal epithelial hyperplasia of the mouth: recently discovered in South Africa. British Journal of Dermatology. 1977;96:381–8. 

13.    Tyldesby WR,Field EA. Oral medicine. 4thed..Liverpole. Oxford Medical Publication; 1995.p.99.

14.    Borborema-Santos CM, Castro MM, Santos PJ, Talhari S, Astolfi-Filho S. Oral focal epithelial hyperplasia: report of five cases. Braz Dent J. 2006;17:79 – 82.

15.    Bodokh I, Lacour JP, Rainero C, Orth G, Perrin C, Hoffman P, Santini J, Ortonne JP. [Focal epithelial hyperplasia. An unusual clinical aspect].Ann Dermatol Venereol. 1993;120:555-7.

16.    Silverman,  Eversole, Truelove. Essentials of oral medicine. London. BC Decker; 2001.P.150.

17.    Morrow DJ, Sandhu HS, Daley TD. Focal epithelial hyperplasia (Heck's disease) with generalized lesions of the gingiva. A case report. J Periodontol. 1993; 64:63-5.

18.    Niebrugge B, Villiers E, Gerlach K, Franke I, GollnickH .Demonstration of HPV 24 in long- standing Heck’s disease with malignant transformation. Eur J Dermatol. 1999;9:477-9.

19.    Stiefler RE, Solomon MP, Shalita AR. Heck's disease (focal epithelial hyperplasia). J Am Acad Dermatol. 1979; 1:499-502.

20.    Cuberos V, Perez J,Lopez CJ,Castro F,Gonzalez LV,CorreaLA,Sanclemente G,Gaviria A,Müller M, Sanchez GI .Molecular and serological evidence of the epidemiological association of HPV 13 with focal epithelial hyperplasia: A case-control study. Journal of Clinical Virology. 2006;37:21-6.