Gut Liver.
2013 Jul;7(4):401-405.
Lichen Planus Is an Uncommon Cause of Nonspecific Proximal Esophageal Inflammation
- Affiliations
-
- 1Centre for Digestive Motility, Division of Gastroenterology, Department of Medicine, University of Calgary Faculty of Medicine, Calgary, AB, Canada. candrews@ucalgary.ca
- 2Department of Pathology and Laboratory Medicine, University of Calgary Faculty of Medicine, Calgary, AB, Canada.
- 3Division of Gastroenterology, Ludwig Maximilian University, Munich, Germany.
Abstract
- BACKGROUND/AIMS
Esophageal lichen planus (LP) has been described as a cause of nonspecific esophagitis that may cause dysphagia, but its incidence is unknown. We aimed to estimate the incidence of esophageal LP in a defined geographic region and describe the clinical characteristics of affected patients.
METHODS
A histopathology database for a population of 1 million people was searched for all esophageal mucosal biopsy results over an 8-year period. Cases showing inflammation or abnormalities without a diagnosis after three or more biopsies were reviewed for findings of LP.
RESULTS
Of 13,589 esophageal biopsies, only one received a diagnosis of LP. Seven patients (four male; mean age, 59 years; range, 39 to 76 years) were identified as having chronic dysphagia and nonspecific proximal esophagitis for which no diagnosis could be made. All patients had proximal inflammation, and six of seven had full-thickness lymphocytic infiltration. Elongation of the lamina propria papillae was noted in all patients, whereas six patients had parakeratosis and ballooning. Only one patient had findings potentially consistent with, but not sufficient for, a diagnosis of esophageal LP.
CONCLUSIONS
Esophageal LP appears to be extremely uncommon in this North American population, and esophageal biopsy alone is likely not sufficient to establish a diagnosis of LP.
