A Venezuelan Refugee Child Diagnosed with Heck’s Disease in a Brazilian Region with Very Low Prevalence: Case Report

Abstract

Heck’s disease, or focal epithelial hyperplasia, is a rare benign oral condition classically associated with human papillomavirus (HPV) types 13 and 32, mainly affecting children and adolescents in specific ethnic groups, particularly indigenous populations. Although cases have been reported in the Brazilian Amazon region, published reports from other Brazilian regions, especially urban centers in the Southeast, remain scarce. We report the case of an 11-year-old Venezuelan refugee boy from the Warao indigenous community who was evaluated at a pediatric dentistry service in the state of São Paulo, Brazil, presenting multiple intraoral papules and nodules. The diagnosis was established by clinicopathologic correlation and was consistent with Heck’s disease. This case highlights the importance of recognizing Heck’s disease in non-endemic urban settings and of including oral mucosal assessment in the care of vulnerable pediatric populations, particularly migrant and refugee children.