title: Doxycycline-induced ulceration mimicking esophageal cancer.
abstract: BACKGROUND
  Doxycycline-induced esophageal ulcer patients are mostly young persons with no history of esophageal dysfunction. Heartburn, midsternal pain and dysphagia are the most common symptoms. It has generally a benign course. The present case is the first report of doxycycline-induced extensive ulcerations, mimicking esophageal cancer in two esophageal segments alongside, in the literature.
  
  
  METHODS
  This report describes a 16-year-old Caucasian girl who, while taking doxycycline capsules100 mg twice a day for acne vulgaris for 3 months, developed these symptoms. An upper endoscopy revealed multiple circumferential deep ulcerations surrounding fragile, irregular, hyperemic and hypertrophic mucosa at the level of the mid-esophagus and concomitantly in the lower esophageal sphincter. The lesions were biopsied to exclude esophageal carcinoma because of the suspicious appearance in the endoscopic examination. The histopathological examination, haematoxylin and eosin stained sections showed ulceration with a mixed inflammatory infiltrate. Doxycycline was discontinued and she was given sucralfate 1 g qid and omeprazole 20 mg bid orally. All symptoms of the patient were resolved on the third day of the treatment. After 4 weeks of the therapy, an upper endoscopic control examination demonstrated normal findings.
  
  
  CONCLUSIONS
  The present case has been an uncommon presentation of doxycycline-induced extensive ulcerations, mimicking esophageal cancer in two esophageal segments, concomitantly. Even the lesions were biopsied to exclude esophageal carcinoma. A modification on the behavior of taking drugs can prevent these unpleasant complications.
authors.affiliation: Department of Gastroenterology, Pasabahce State Hospital, Istanbul, Turkey. veytahan@yahoo.com.
authors.forename: Veysel
authors.initials: V
authors.lastname: Tahan
authors.forename: Hakan
authors.initials: H
authors.lastname: Sayrak
authors.forename: Nevzat
authors.initials: N
authors.lastname: Bayar
authors.forename: Burak
authors.initials: B
authors.lastname: Erer
authors.forename: Gulgun
authors.initials: G
authors.lastname: Tahan
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
references.citation: Dig Dis Sci. 1983 Feb;28(2):174-82
references.pmid: 6825537
references.citation: Therapie. 1997 Nov-Dec;52(6):587-9
references.pmid: 9734112
references.citation: Dis Esophagus. 2004;17(2):168-71
references.pmid: 15230733
references.citation: Mil Med. 2001 Mar;166(3):203, 222
references.pmid: 11263018
references.citation: J Clin Gastroenterol. 2004 Jul;38(6):484-9
references.pmid: 15220682
references.citation: J Pediatr. 1992 Jan;120(1):144-5
references.pmid: 1731012