Esophageal lichen planus

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Patient

  • 55-year-old female.

Presentation 

  • Progressive dysphagia for solid foods for 6 months.
  • Oral lichen planus treated with steroids for five years.
  • No history supporting other causes of dysphagia (Reflux- corrosives – Drug induced).

Investigations

  • Barium swallow: showed a long segment benign stricture of the upper thoracic esophagus.
  • Endoscopy : showed narrowing of upper thoracic esophagus and mucosal erosions proximal to the stricture.
  • Histopathology: Lymphocytic inflammatory infilterate.

Diagnosis

Esophageal lichen planus.

Management

Esophageal dilatation using endoscpe.

Tips

  • Female patients with oral LP should be questioned about symptoms related to esophageal involvement and examined for other mucosal lesions.
  • Esophageal involvement usually affects the upper and mid mid-esophagus, while reflux esophagitis mainly affects the gastroesophageal junction.

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References:

  • Madhusudhan, K. S., & Sharma, R. (2008). Esophageal lichen planus: a case report and review of literature. Indian journal of dermatology53(1), 26.‏

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