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Focal Epithelial Hyperplasia

Focal Epithelial Hyperplasia
Etiology • A viral infection (HPV 13 or 32), usually found in childhood • Familial/ethnic clustering often noted, probably secondary
through horizontal viral transmission • Often occurs in native Americans
Clinical Presentation • Numerous, slightly raised whitish pink asymptomatic papules
and irregular plaques that may become confluent • Size of lesions ranges from a few millimeters to coalescent
papules several centimeters in dimension

Microscopic Findings • Well-defined acanthotic features • Broadened, anastomosing epithelial ridges with occasional
superficial koilocytotic changes
Diagnosis • Multiple, characteristic lesions • Biopsy findings • In situ deoxyribonucleic acid hybridization to demonstrate
HPV subtype • Ultrastructural localization of intranuclear virions
Differential Diagnosis • Condyloma acuminatum • Multiple verruca vulgaris
Treatment • None; lesions usually regress spontaneously • Excision if esthetic needs demand • Intralesional interferon therapy
Prognosis • Excellent • No reported malignant transformation