FOCAL EPITHELIAL HYPERPLASIA (HECK’S DISEASE): A REVIEW WITH EMPHASIS ON DIAGNOSIS AND TREATMENT

Focal epithelial hyperplasia (FEH), otherwise known as Heck’s disease or multifocal papilloma was described as a rare, benign, and asymptomatic oral mucosal proliferation with a distinguished painless, multiple, slightly elevated, sessile papules that has an even surface, with normal oral mucosal color which occasional whitish discoloration, and a diameter of 5-10mm. Although frequently found on the labial, buccal, tongue, and gingival mucosa, rarely, it may present on the palate and tonsillar region; with lower labial mucosa being affected more frequent than the upper. The major presenting complaint of patients is esthetic concern. There is scanty organized literature on this relatively rare, yet an important clinical condition especially in this clime. The research will aid clinicians by providing clear diagnostic and management pathways of the disease. Search was done via databases between January 2024 to February 2024, from Pubmed, Google Scholar, MEDLINE, Researchgate, Academia and CINAHL without date limit. The phrases “Focal epithelial hyperplasia” “Multifocal epithelial hyperplasia” and “Heck’s disease” were used to find related articles. Included in this review was total of twenty-seven publications whereby the clinical presentation and management of this condition were discussed. Findings from the literature suggest that the disease is more prevalent in Europe, commonly found in children, and esthetic concern as the major presenting complaint. In conclusion, Heck’s disease is a rare condition especially in adults, sometimes diagnosed as an incidental finding due to lack of associated pain. Most patients present as a result of esthetic concern which underscores the need for clinicians to explore non-invasive management approach in order to subvert the negative intraoperative and postoperative effects of conventional surgical excision. The aim of this research is to present a general review of the literature on the clinical presentation and management of focal epithelial hyperplasia (Heck’s disease).