Multiple flat papules on the lips of children

Abstract

Case report. A 6-year-old Brazilian boy was referred by his pediatric dentist. The child presented with asymptomatic, coalescent, papillomatous lesions which had appeared six months previously and affected the mucosa of both lower and upper lips (Fig. 1, 2). The patient was otherwise healthy and his physical examination showed no significant abnormality. The family history revealed that the child's grandparents were of indigenous origin. The diagnosis of focal epithelial hyperplasia (Heck´s disease) was done on clinical grounds, based on the following characteristic findings: a child of indigenous descent presenting with multiple, soft, pink, exophytic, flat-topped papules on the oral mucosa, especially involving the buccal and labial mucosa. Given the benign nature of these lesions which usually regress on their own, and the fact that there were no symptoms or esthetical concerns, the patient did not receive any treatment. He was controlled over a two-year period, during which no clinical alteration of the lesions was observed.