title: The challenges of managing refractory oesphageal lichen planus.
abstract: BACKGROUND
  Lichen planus is an inflammatory mucocutaneous disorder, often idiopathic. It is postulated that the characteristic skin lesions arise from a T cell mediated autoimmune response against basal keratinocytes. Oral mucosal involvement can occur in up to 70 % of cases of cutaneous disease however, oesphageal involvement is rare.
  
  
  RESULTS
  We report the case of a 60 year old female with ulcerative oesphagitis and concomitant cutaneous lesions suggestive of lichen planus. Multiple immunosuppressant therapies were administered but with little success, except for pulses of oral steroids.
  
  
  CONCLUSIONS
  Oesphageal lichen planus is rare, often unrecognised and can be resistant to treatment. However, diagnosis is crucial as malignant transformation of longstanding ulcerative lichen planus may occur.
authors.affiliation: Department of Dermatology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland, eustacekaren@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Eustace
authors.forename: J
authors.initials: J
authors.lastname: Clowry
authors.forename: C
authors.initials: C
authors.lastname: Kiely
authors.forename: G M
authors.initials: GM
authors.lastname: Murphy
authors.forename: G
authors.initials: G
authors.lastname: Harewood
mesh_terms: D004935:Esophageal Diseases / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008010:Lichen Planus / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D012871:Skin Diseases / Q000188:drug therapy* / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents