Lichen planus esophagitis: report of three patients treated with oral tacrolimus or intraesophageal corticosteroid injections or both*

Abstract

Clinically significant involvement of the esophagus is uncommon in patients who have lichen planus, a common disorder of squamous epithelium. In three patients who had oral, cutaneous, and esophageal lichen planus, endoscopic intralesional esophageal injection of corticosteroids (in all three patients) and oral tacrolimus (FH506) (in two patients) resulted in improvement in dysphagia, a less frequent need for dilation, and improvement in esophageal inflammation.

Lichen planus of the esophagus: What dermatologists need to know

“…29 Intralesional corticosteroids accompanied by oral tacrolimus (administered as 0.1% in Aquaphor (Beiersdorf, Wilton, CT) directly to oral areas followed by swallowing the remainder) has also been successful. 32 Because the presence of ELP in areas with concomitant reflux esophagitis may be an example of the Koebner phenomenon, 8 adjunctive treatment with acid reflux prevention may be helpful in protecting already injured esophageal epithelium from further damage. 29 In some cases, medication intolerance or a suboptimal side-effect profile requires close endoscopic surveillance with intermittent dilatations in lieu of aggressive systemic therapy.…”

Esophageal Lichen Planus: Case Report and Literature Review

“…Oral cyclosporine has been used successfully [4], but this did not help our patient. Topical tacrolimus has been used for oral lichen planus and in these patients an improvement of esophageal symptoms was noted and the frequency of dilatations for the known esophageal stricture was reduced [5]. Unfortunately, our patient again failed to respond.…”

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

“…Different systemic therapies are described. Systemic corticosteroids are supposed to be most effective as well as retinoids, cyclosporine, azathioprine, tacrolimus, rituximab and griseofulvin or intralesional corticosteroids [71,72,76,77,78,79,80,81,82,83,84,85,86]. …”