title: Esophageal Lichen Planus: Clinical and Radiographic Findings in Eight Patients.
abstract: OBJECTIVE
  The purpose of this study is to present the clinical and radiographic findings of esophageal lichen planus.
  
  
  METHODS
  A search of computerized medical records identified 15 patients with pathologic findings of esophageal lichen planus on endoscopic biopsy specimens. Three other patients had presumed esophageal lichen planus, although no biopsy specimens were obtained. Twelve of these 18 patients (67%) had double-contrast esophagography performed at our institution; for eight of the 12 patients (67%), the studies revealed abnormalities in the esophagus. These eight patients constituted our study group. The barium esophagrams and medical records of these eight patients were reviewed to determine the clinical, radiographic, and endoscopic findings of esophageal lichen planus as well as the treatment and patient outcome.
  
  
  RESULTS
  All eight patients were women (median age, 66.5 years), and all eight presented with dysphagia (mean duration, 3.2 years). Four patients had previous lichen planus that involved the skin (n = 1), the oral cavity (n = 2), or both (n = 1), and one patient later had lichen planus that involved the vagina. Five patients had a small-caliber esophagus with diffuse esophageal narrowing. The remaining three patients had segmental strictures in the cervical (n = 1), upper thoracic (n = 1), and distal thoracic (n = 1) esophagus.
  
  
  CONCLUSIONS
  Esophageal lichen planus typically occurs in older women with longstanding dysphagia and often develops in the absence of extraesophageal disease. Barium esophagrams may reveal a small-caliber esophagus or, less commonly, segmental esophageal strictures. Greater awareness of the radiographic findings of esophageal lichen planus hopefully will lead to earlier diagnosis and better management of this condition.
authors.affiliation: 1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Rauschecker
authors.affiliation: 1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
authors.forename: Marc S
authors.initials: MS
authors.lastname: Levine
authors.affiliation: 2 Gastroenterology Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Whitson
authors.affiliation: 3 Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Tondon
authors.affiliation: 1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Rubesin
authors.affiliation: 3 Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Emma E
authors.initials: EE
authors.lastname: Furth
authors.affiliation: 2 Gastroenterology Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: David C
authors.initials: DC
authors.lastname: Metz
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004935:Esophageal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008010:Lichen Planus / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: barium esophagography; esophageal lichen planus; esophagography; esophagus; lichen planus