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World J Gastroenterol. Nov 7, 2022; 28(41): 5893-5909
Published online Nov 7, 2022. doi: 10.3748/wjg.v28.i41.5893
Esophageal lichen planus: Current knowledge, challenges and future perspectives
Annegrit Decker, Franziska Schauer, Adhara Lazaro, Carmen Monasterio, Arthur Robert Schmidt, Annette Schmitt-Graeff, Wolfgang Kreisel
Annegrit Decker, Carmen Monasterio, Arthur Robert Schmidt, Wolfgang Kreisel, Department of Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg 79106, Germany
Franziska Schauer, Department of Dermatology, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg 79104, Germany
Adhara Lazaro, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
Annette Schmitt-Graeff, Institute for Dermatohistology, Pathology, and Molecular Pathology Prof. Dr. Laaf, Freiburg, Germany and: University of Freiburg, Freiburg 79106, Germany
Author contributions: Decker A, and Kreisel W designed the manuscript; Schmitt-Graeff A performed the histological evaluation; Schauer F evaluated dermatological findings and performed direct immunofluorescence; All authors collected and interpreted data from patients of their own cohort and from literature; All authors contributed to writing the text. The final stylistic corrections were made by Lazaro A.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wolfgang Kreisel, MD, Emeritus Professor, Department of Medicine II, Gastroenterology, Hepatology, Endocrinology, and Infectious Diseases, Faculty of Medicine, Medical Center-University of Freiburg, Hugstetter Str. 55, Freiburg 79106, Germany.
Received: July 28, 2022
Peer-review started: July 28, 2022
First decision: August 31, 2022
Revised: September 17, 2022
Accepted: October 27, 2022
Article in press: October 27, 2022
Published online: November 7, 2022
Core Tip

Core Tip: Lichen planus (LP) is a frequent, chronic inflammatory disease involving the skin, mucous membranes and/or skin appendages. Esophageal involvement in lichen planus (ELP) is an underdiagnosed inflammatory condition. ELP mainly affects middle-aged women. The principal symptom is dysphagia. Aymptomatic cases may occur. An immune-mediated pathogenesis is probable. Endoscopy shows mucosal denudation and tearing, trachealization, and hyperkeratosis. Scarring esophageal stenosis occurs. Histology includes mucosal detachment, T-lymphocytic infiltrations, epithelial apoptosis, dyskeratosis, and hyperkeratosis. Direct immuno-fluorescence shows fibrinogen deposits along the basement membrane zone. Treatment with topical steroids or immunosuppression may induce symptomatic and histologic improvement. ELP can be regarded as a precancerous condition.