Esophagus
Nonneoplastic disorders
Lichen planus

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 16 January 2018, last major update December 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Lichen planus esophagus

Cite this page: Weisenberg, E. Lichen planus. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophaguslichenplanus.html. Accessed November 21st, 2018.
Definition / general
  • Subacute to chronic mucocutaneous disorder of unknown etiology that involves skin, nails and mucosal surfaces
  • In esophagus, tends to be chronic and cause dysphagia due to esophagitis and stricture formation
  • May be underdiagnosed and a risk factor for squamous cell carcinoma (Am J Surg Pathol 2000;24:1678, Eur J Gastroenterol Hepatol 2006;18:1043)
Epidemiology
  • 2/3 women, usually age 40+ years
Sites
  • Mucosal surfaces affected are usually perineum, oral mucosa and pharynx
  • Rarely involves esophagus, usually upper or mid esophagus
Case reports
Treatment
  • Systemic corticosteroids, retinoids, cyclosporine or azathioprine; may relapse when therapy is stopped
Microscopic (histologic) description
  • Lichenoid ("banded, parallel to epidermis"), T cell rich lymphocytic infiltrate, basal epithelium degeneration, Civatte bodies (degenerated epithelial cells); often parakeratosis and atrophic epithelium; usually no hypergranulosis
Microscopic (histologic) images

Images hosted on other servers:

Various skin images

Differential diagnosis
  • Gastroesophageal reflux disease: clinical symptoms, intraepithelial eosinophils, usually lower esophagus
  • Gold therapy, thiazides or antimalarials also cause cause lymphocytic infiltrate