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A Case Report of Progressive Dysphagia and Pigmented Oral and Skin Lesions: Esophageal Lichen Planus



Afifian M1 ; Hormati A2, 3 ; Ebadizadeh R2
Authors
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Authors Affiliations
  1. 1. Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
  3. 3. Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran

Source: Journal of Mazandaran University of Medical Sciences Published:2020

Abstract

Lichen planus (LP) is a relatively uncommon, chronic inflammatory disease with idiopathic pathogenesis that usually involves skin, nails, and mucous membranes. Esophageal involvement in LP is rarely seen, despite the classification of the esophagus as a mucous membrane. Esophageal lichen planus is common in middle aged women, with symptoms such as dysphagia and odynophagia. This paper presents the case of a middle aged woman with dysphagia to solid foods. She underwent diagnostic measures including upper esophagogastroduodenoscopy which showed severe stenosis in upper and middle third of the esophagus. In multiple times, the patient underwent endoscopic dilation due to recurrence of stenosis but the effect was slight and transient. Fibrosis was reported in repeated biopsies taken from esophagus. According to clinical and endoscopic findings and a high suspicion of LP, biopsy of the lip was done which confirmed lichen planus. Due to frequent recurrence of stenosis in this area, along steroid therapy, removable fully covered stent was placed for four weeks. The patient was under follow-up for two years and the stenosis did not recur. © 2020, Mazandaran University of Medical Sciences. All rights reserved.