Heck's disease, also known as Focal Epithelial Hyperplasia, is an asymptomatic, benign neoplastic condition characterized by multiple white to pinkish papules that occur diffusely in the oral cavity.[1][2]: 411 Can present with slightly pale, smooth or roughened surface morphology. It is caused by the human papilloma virus types 13 and 32.[3] It exhibits surface cells with vacuolated cytoplasm around irregular, pyknotic nuclei and occasional cells with mitosis-like changes within otherwise mature and well-differentiated epithelium. A distinguishing histologic feature is elongated rete ridges with mitosoid bodies. It shows 'cobblestone' appearance clinically. It was first identified in the Aboriginal population of North America.[4]
Over time, they will spontaneously regress without treatment.[5] Possible treatment may be excisional biopsy for lesions of functional or aesthetic concern.[citation needed]
^Archard, Howell O; Heck, John W; Stanley, Harold R (1965). "Focal epithelial hyperplasia: An unusual oral mucosal lesion found in Indian children". Oral Surgery, Oral Medicine, Oral Pathology. 20 (2): 201–12. doi:10.1016/0030-4220(65)90192-1. PMID14322615.
