Management of symptomatic esophageal involvement with lichen planus.
OBJECTIVE
To describe the clinical features and treatment schedules of a series of 5 patients with esophageal lichen planus (LP). To review the literature on esophageal LP.


BACKGROUND
LP, a common papulosquamous dermatologic condition, can present to the gastroenterologist with esophageal involvement. This is rare and occurs in a distinct population of LP patients. Disease at this site is frequently refractory to conventional treatment.


METHODS
Between 2001 to 2007, 5 female patients were diagnosed with esophageal LP. They all had esophageal strictures which were treated with a combination of balloon dilatation and intralesional triamcinolone. Therapeutic intervention was covered with oral steroids before and after the procedure. Symptoms tended to recur, necessitating repeat procedures. The average interval between treatments was 8.3 months.


CONCLUSIONS
Intralesional triamcinolone and balloon dilatation produced good symptomatic relief in these 5 patients with esophageal LP. This was generally maintained for several months. We reviewed 35 cases of symptomatic esophageal LP in the English literature. Esophageal LP seems to have a striking predilection for middle-aged women, particularly those with disease at other mucosal sites. A range of systemic immunosuppressants and esophageal-directed therapies has been tried.
Wedgeworth
Emma K
EK
St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Trust, London, England. ekw99@doctors.org.uk
Vlavianos
Panagiotis
P
Groves
Christopher J
CJ
Neill
Sallie
S
Westaby
David
D
D002404:Catheterization / Q000379:methods*; D003131:Combined Modality Therapy; D004935:Esophageal Diseases / Q000473:pathology / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D008010:Lichen Planus / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D012008:Recurrence; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use*
D005938:Glucocorticoids; D014221:Triamcinolone