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Heck’s disease, or Focal Epithelial Hyperplasia (FEH), caused by Human Papilloma Virus (HPV) subtypes 13 and mainly 32, is a rare and benign pathology of the oral mucosa; diagnosis is confirmed by PCR analysis. This is a common disease in the Mayan and other Native-American populations, most frequently between 2-13 years. Risk factors include lower income class, poor hygiene and genetic predisposition. This cross-sectional study aims to determine the prevalence of clinically compatible lesions of FEH in children from low, middle and high-income in 3 elementary schools in Yucatan, Mexico. Clinical evaluation was conducted and documented for later analysis by a dermatologist familiar with FEH. Samples were taken and HPV-13 was identified by PCR. The total of 186 subjects were analyzed from the low-income elementary school, with 41 subjects presenting FEH lesions and 76 presented HPV-13 upon PCR analysis. In the middle-income school, of the 144 subjects studied, 3 had FEH lesions and 8 presented HPV-13 upon PCR analysis. In the high-income elementary school, 96 students were studied, and none presented FEH lesions, however, 6 had HPV-13 positivity. FEH and HPV-13 prevalence were inversely proportional to socioeconomic status. Lacking an association to a particular gender or difference in the age groups studied.

journal of immunobiology

Focal Epithelial Hyperplasia Prevalence in an Endemic Population, Molecular Association of HPV-13 to Asymptomatic Patients and Comparison Between Three Elementary Schools of Different Income Levels