An 11-year-old Caucasian male patient was referred to the Ambulatory of Stomatology at the Hospital de Clínicas de Porto Alegre because of multiple papillomatous lesions dispersed through the oral mucosa.
The patient's mother reported similar lesions in her sister, which were treated by cauterization.
In the intraoral physical analysis, multiple papillomatous lesions were observed, some of them with nodular appearance, others with appearance of faces, of the same coloration of the oral mucosa and painless.
The lesions were located in the bilateral labial commissure, in the retrocommissural zone, bilateral, in the mucosa of the upper and lower lip, in the anterior edge of the tongue and in the posterior third of the hard palate.
The size of the lesions ranged from 0.5 to 5 mm in diameter.
The clinical suspicion was Epithelial Focal Hyperplasia.
Excisional biopsy of one of the lesions was performed, located in the labial commissure right side.
Histopathology showed epithelial acanthosis, presence of interpatellar crests enlarged, koilocytosis and nuclear alteration, known as mitosoid figure.
The presence of HPV 13 virus was tested by immunohistochemical analysis.
These characteristics lead to a definitive diagnosis of Focal Epithelial Hyperplasia.
The patient's mother was informed about the characteristics of benignity of the disease and lesions are expected to decrease.
The patient is being followed-up every six months.
