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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Dec 20, 2025; 15(4): 114368
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.114368
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.114368
Multifocal epithelial hyperplasia: Clinical features, diagnosis and management challenges
Cesar Omar Ramos-Gregorio, Omar Tremillo-Maldonado, Marcelo GómezPalacio-Gastélum, Ronell Bologna-Molina, Master Degree Program, Faculty of Dentistry, Universidad Juarez del Estado de Durango, Durango 34070, Mexico
Felipe Silveira, Lauren Frenzel Schuch, Vanesa Pereira-Prado, Estefania Sicco, Ana Cristina Soto-Najera, Ronell Bologna-Molina, Department of Diagnostic in Oral Pathology and Oral Medicine, Faculty of Dentistry, Universidad de la República, Montevideo 11400, Uruguay
Mario Isiordia-Espinoza, División de Ciencias Biomédicas, Universidad de Guadalajara Centro Universitario de los Altos, Tepetitlan de Morelos 47620, Jalisco, Mexico
Juan José Muñoz-Ibarra, Faculty of Dentistry, Universidad Anáhuac Mayab, Merida 93308, Yucatán, Mexico
Victor Toral-Rizo, Faculty of Dentistry, University of the Mexico State, Toluca 50130, Mexico
Author contributions: Ramos-Gregorio CO, Bologna-Molina R performed the literature search, interpreted the relevant literature, and drafted the initial manuscript; Bologna-Molina R, Ramos-Gregorio CO, Soto-Najera AC, GómezPalacio-Gastélum M, Isiordia-Espinoza M, Muñoz-Ibarra JJ and Toral-Rizo V and Tremillo-Maldonado O conceived the idea and provided additional input to design the paper; Silveira F, Frenzel Schuch L, Pereira-Prado V and Sicco E prepared the figures and tables and revised the article critically and preformed the final changes.
Conflict-of-interest statement: The authors do not have any conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ronell Bologna-Molina, PhD, Professor, Department of Diagnostics in Oral Pathology and Oral Medicine, Faculty of Dentistry, University of the Republic, General Las Heras 1925, Montevideo 11600, Uruguay. ronellbologna@hotmail.com
Received: September 17, 2025
Revised: October 3, 2025
Accepted: December 4, 2025
Published online: December 20, 2025
Processing time: 93 Days and 13 Hours
Revised: October 3, 2025
Accepted: December 4, 2025
Published online: December 20, 2025
Processing time: 93 Days and 13 Hours
Core Tip
Core Tip: Multifocal epithelial hyperplasia (MEH), or Heck's disease, is a rare, benign oral mucosal condition linked primarily to low-risk human papillomavirus genotypes 13 and 32. It disproportionately affects marginalized Indigenous American people, especially children and adolescents, driven by factors such as overcrowding and malnutrition. Clinically, MEH manifests as asymptomatic, multiple oral papules or nodules with a distinctive "cobblestone-like" appearance. Diagnosis is enhanced by molecular tools. Although generally self-limiting, improved diagnostic access, targeted vaccines, and tailored public health interventions are crucial for vulnerable communities.