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      Hiperplasia Epitelial Focal: ¿por qué Enfermedad de Heck? Translated title: Focal epithelial hyperplasia: why Heck's disease?

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          Abstract

          La hiperplasia focal del epitelio se caracteriza por la presencia de elevaciones papulares o nodulares, sésiles, de aspecto liso o rugoso, múltiples, de la misma coloración de la mucosa (Neville et al., 1998). Estrada (1956) describió la presencia de verrugas intraorales y lesiones papilomatosas en indios Caramantas en Colombia en 1956. El mismo autor verificó la presencia de esas mismas lesiones en indios Kátios, también colombianos, en el año de 1960. Reyes (1962) notó esa misma condición clínica en Guatemala. Soneira y Fonseca (1964) describieron la lesión con sus variaciones clínicas, desde una pápula a múltiples lesiones papilomatosas en la mucosa oral, labios, entre otras regiones de la mucosa bucal. Estos autores estudiaron 160 niñas indias en Venezuela y observaron la enfermedad en 54 de ellas (33,75%). Ellos también sugieren que la enfermedad tenga una etiología viral. A pesar de que esta entidad haya sido descrita por otros autores latinoamericanos antes de 1965, a ella se la reconoció internacionalmente ese año a través de Archard, Heck y Stanley. Estos autores relataron casos aislados en 15 indios norteamericanos del estado de Nuevo México; un Xavante, del estado de Mato Grosso (Brasil) y un caso en un niño esquimal de Alaska y pasaron a denominar la entidad Hiperplasia Focal del Epitelio. El epónimo "Enfermedad de Heck" se deriva del Dr. Heck, que identificó a un paciente con esta enfermedad en Gallup, en Nuevo México, en 1961. Practorius-Clausen y Willis (1971) fueron los primeros a demostrar partículas del HPV en la hiperplasia focal del epitelio. Con referencia a las publicaciones anteriores a aquella de Archard, Heck y Stanley (1965), los autores sugieren que el epónimo Enfermedad de Heck sea abandonado, pues esa denominación además de no dar crédito a los autores que la describieron anteriormente a la comunicación de 1965, no suministra ninguna idea con relación a la naturaleza y característica de la entidad. Los autores también relatan un caso de hiperplasia focal del epitelio en paciente del sexo masculino, 13 años, leucodemia.

          Translated abstract

          The focal epithelial hyperplasia is characterized by the presence of papular and nodular elevations, flat or rough multiple sessiles, with the same color of the mucous membrane (Neville et al., 1998). Estrada (1956) described the presence of intra-oral warts and papillary lesions in Caramantas natives in Colombia, in 1956. IN 1960, the same author identified the presence of the same lesions in Kátios natives, from Colombia. Reyes (1962) noticed the same clinical conditions in Guatemala. Soneira and Fonseca (1964) have described the lesion with its clinical variations, from a single papula to multiple papillary lesions in the oral mucosa, lips, and other oral regions. These authors studied 160 native girls in Venezuela and noticed the disease in 54 of them (33.75%). They also suggest that the disease has a viral etiology. In spite of the fact the disease was described by other Latin American authors before 1965, it was worldwide recognized only in this year, due to Aechard, Heck and Stanley. These authors have reported isolated cases in 15 North American natives in the State of New Mexico; one Xavante in the state of Mato Grosso (Brazil) and a Eskimo boy in Alaska, and named the disease as Focal Epithelial Hyperplasia. The eponym "Heck Disease" is derived from Dr. Heck, who identified one patient with this disease in Gallup, New Mexico in 1961. Praetorius-Clausen and WiIlis (1971) were the first to show HPV particles in the focal epithelial hyperplasia. Concerning the publishing prior to Archard, Heck and Stanley (1965), the authors suggest to discard that the eponym "Heck Disease", since this denomination does not add any relation to the nature and characteristics of the disease, and also does not recognize the authors who had described it before 1965. The authors also report a focal epithelial hyperplasia in a male 13 year old patient, leukoderma.

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          Most cited references 76

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          FOCAL EPITHELIAL HYPERPLASIA: AN UNUSUAL ORAL MUCOSAL LESION FOUND IN INDIAN CHILDREN.

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            A papillomavirus related to HPV type 13 in oral focal epithelial hyperplasia in the pygmy chimpanzee.

            An epizootic of focal epithelial hyperplasia (FEH) or Morbus Heck in a pygmy chimpanzee (Pan paniscus) colony is described. Papovavirus-like particles were observed in the nuclei of epithelial cells. Analysis of the DNA of the lesions revealed an episomal papillomavirus-specific band with a molecular size of approximately 8,000 bp. In situ hybridization under high stringency conditions showed cross-hybridization between the chimpanzee papillomavirus DNA and human papillomavirus (HPV) type 13. The latter virus is uniquely associated with oral disease in man. This is the first demonstration of the association of a HPV 13-related pygmy chimpanzee papillomavirus (PCPV) and oral epithelial hyperplasia in a nonhuman primate.
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              Multifocal papilloma virus epithelial hyperplasia.

               R. Carlos,  H SEDANO (1994)
              Multifocal papilloma virus epithelial hyperplasia is an infection of the oral mucosa produced by human papilloma virus types 13 and 32, which primarily bilaterally affects lips, lateral borders of tongue, and buccal mucosa. The attached oral mucosa, floor of mouth, soft palate, and oropharynx are sites that appear not to be affected. This study comprises 110 patients with multifocal papilloma virus epithelial hyperplasia identified over a period of 3 years in Guatemala City and neighboring rural areas. All but four patients were younger than 18 years of age. More than one affected patient was observed in several families. All but three cases occurred in patients living in extreme poverty (annual family income less than $1,200 in U.S. dollars). Biopsies of 60 lesions demonstrated acanthosis and nuclear degeneration within the epithelium. We suggest that the eponym Heck's disease be abandoned because this disease was described in the Latin-American literature before the initial description in the American literature. We propose the term multifocal papilloma virus epithelial hyperplasia, which best describes the nature and multifocality of this disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                October 2003
                : 19
                : 5
                : 239-247
                Affiliations
                orgnameUniversidad Federal do Rio Grande do Sul orgdiv1Facultad de Odontologia
                orgnameHospital de Clínicas do Porto Alegre orgdiv1Ambulatorio de Estomatologia
                Article
                S0213-12852003000500005
                10.4321/s0213-12852003000500005

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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