title: Lichen planus is an uncommon cause of nonspecific proximal esophageal inflammation.
abstract: OBJECTIVE
  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.
authors.affiliation: Centre for Digestive Motility, Division of Gastroenterology, Department of Medicine, University of Calgary Faculty of Medicine, Calgary, AB, Canada.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Linton
authors.forename: Liena
authors.initials: L
authors.lastname: Zhao
authors.forename: Xianyong
authors.initials: X
authors.lastname: Gui
authors.forename: Martin
authors.initials: M
authors.lastname: Storr
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Andrews
keywords: Esophagitis; Esophagus; Gastroesophageal reflux disease; Inflammation; Lichen planus
references.citation: Lancet. 2006 Jun 24;367(9528):2086-100
references.pmid: 16798392
references.citation: Dysphagia. 2008 Sep;23(3):331-4
references.pmid: 18575934
references.citation: Arch Pathol Lab Med. 2008 Jun;132(6):1026-9
references.pmid: 18517264
references.citation: Clin Gastroenterol Hepatol. 2010 Sep;8(9):777-82
references.pmid: 20471494
references.citation: BMJ. 1990 Jan 13;300(6717):84
references.pmid: 2105780
references.citation: J Clin Gastroenterol. 2010 Nov-Dec;44(10):663-71
references.pmid: 20838233
references.citation: Clin Gastroenterol Hepatol. 2009 Mar;7(3):A24
references.pmid: 18986843
references.citation: Endoscopy. 2009 Mar;41(3):187-93
references.pmid: 19280529
references.citation: Gastrointest Endosc. 1997 Jan;45(1):38-45
references.pmid: 9013168
references.citation: Adv Anat Pathol. 2009 May;16(3):161-5
references.pmid: 19395879
references.citation: J R Soc Med. 2006 Jun;99(6):318-20
references.pmid: 16738377