Treatment of focal epithelial hyperplasia with trichloroacetic acid

Abstract

Focal epithelial hyperplasia is a benign disease which has a chronic course that manifests as characteristic multiple small papules or nodules. They are predominantly found in the oral mucosa, gingiva and tongue. The surface of the lesions is smooth and it varies in size. It is an asymptomatic disease caused by human papillomavirus, affecting mainly children and adolescents. In this report, we describe four cases referred to the Stomatology and Oral Surgery Department of the Faculty of Dentistry, Cartagena University with a diagnosis of focal epithelial hyperplasia. Clinical features and histopathological characteristics of the patients were recorded. We also describe the properties and advantages of trichloroacetic acid as a therapeutic method.

Trichloroacetic Acid for localized juvenile spongiotic gingival hyperplasia: A case report with a novel treatment

“…Although TA is usually used to treat skin lesions, the application on the oral mucosa was described as a safe alternative in oral Human Papilloma Virus infections with a high rate of success and low morbidity. The main complication described is the presence of ulcerative lesions [8]. Regarding the therapeutic schemes, some authors recommended concentrations between 80 and 90% [8].…”

“…The main complication described is the presence of ulcerative lesions [8]. Regarding the therapeutic schemes, some authors recommended concentrations between 80 and 90% [8]. With the aim to treat post surgical recurrence, TA was carefully applied with a microbrush over the lesion one time per week on five separate occasions, showing marked improvement at each visit.…”

“…5A). In order to eliminate TA residues that could affect adjacent tissues and neutralize pH, a rinse with a mixture of water and bicarbonate was recommended [8]. TA ingestion is an extremely rare event and fortunately its absorption into the bloodstream is not significant.…”

Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity

“…The diagnosis of Heck's disease is mainly based on the clinical picture and histopathological findings. The prominent microscopic features consist of parakeratin layering, extensive acanthosis, epithelial cells of the spinous layer with enlarged nucleus, degeneration of koilocytes, and mitosoid cells [ 6 ]. Our case demonstrated multiple papillary epithelial projections with fibrovascular connective tissue cores and presence of koilocytes in the spinous layer of the epithelium favouring the diagnosis.…”

“…Lesions that do not remit or cause functional and/or aesthetic problems can be removed by various modalities like surgery, cryotherapy, electrocoagulation, laser, chemical agents (e.g., retinoic acid), or immunostimulants (e.g., interferon) [ 4 ]. Harris Ricardo et al treated 4 cases of focal epithelial hyperplasia using 80% of trichloroacetic acid and observed resolution of the lesions within 45 days [ 6 ]. The prognosis of the disease is good, as most of the lesions remit spontaneously, although periodical clinical followups are crucial [ 4 ].…”