Lichen Ruber Mucosae with Esophageal Involvement

Maercke, P. Van; Günther, Mattias; Groth, W.; Gheorghiu, T; Habermann, U.

doi:10.1055/s-2007-1018165

Cited by 21 publications

(11 citation statements)

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“…Retinoid therapy was successful in only 1 of the 4 cases reported [13], and moreover, it was hardly tolerated by the patients [20, 22]. …”

Section: Discussionmentioning

confidence: 99%

“…Oesophageal involvement in lichen planus is very rare, only 17 cases [7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]and a series of 6 patients in 15 years from the Mayo Clinic [23]have been reported in the literature so far. This complication is probably underestimated, since a small study in 1990 on 19 patients with OLP demonstrated that a quarter of those had oesophageal involvement [24](table 1).…”

Section: Introductionmentioning

confidence: 99%

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Lichen planus with Oesophageal Involvement

Menges¹,

Hohloch²,

Pueschel

et al. 2002

Digestion

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Background: Lichen planus is a common mucocutaneous disease of unknown aetiology. Oral disease affecting the mouth and the pharynx occurs in 30–70% of the cases. Oesophageal disease is considered to be extremely rare. The diagnosis of oesophageal involvement is often not made until complications occur. Case Report: A 56-year-old woman with oral and genital erosive lichen planus for more than 4 years complained of odynophagia and dysphagia. Episodes of oesophageal bolus obstruction started 2 months earlier. Upper endoscopy revealed a high-grade concentric stenosis at 21–24 cm from the incisors. Biopsy specimens taken after bougienage showed a squamous epithelium with dense leukocyte infiltration and Civatte bodies. The bougienage led to complete relief, but due to recurrent symptomatic stenosis, endoscopic dilatation had to be performed another four times within 5 years of follow-up. Immunosuppressive therapy with systemic and local steroid application did not prevent recurrent stenosis. Conclusions: Patients with lichen planus should be evaluated for gastrointestinal symptoms because oesophageal involvement is a rare but severe complication leading to inflammatory stenosis. The benefit of immunosuppressive therapy in the prevention of recurrent stenosis is not established. A review of all reported cases is done with particular regard to therapy.

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“…Retinoid therapy was successful in only 1 of the 4 cases reported [13], and moreover, it was hardly tolerated by the patients [20, 22]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lichen planus with Oesophageal Involvement

Menges¹,

Hohloch²,

Pueschel

et al. 2002

Digestion

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“…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]. …”

Section: Discussionmentioning

confidence: 99%

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

Kolios¹,

Maggio²,

Gubler

et al. 2013

Dermatology

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Background: Therapy-resistant lichen planus (LP) can be a challenging condition for dermatologists. There are some case reports about successful treatments with alitretinoin of cutaneous and oral, but not of esophageal LP. Objective: We present the unique case of a patient with cutaneous, oral and esophageal LP which was refractory to classical treatment options (topical clobetasol propionate and pimecrolimus, intramuscular triamcinolone acetonide); because of systemic side effects the patient did not tolerate systemic acitretin dosed up to 25 mg daily. Methods: Oral alitretinoin was used at a dose of 30 mg daily. Results: Both oral and skin changes as well as dysphagia completely resolved within 4 weeks without any severe side effects and the drug was used for 6 months. No papules, intraoral striae or dysphagia recurred during the 6 months of treatment. After 4 months the patient relapsed with mucosal patches so that a second cycle was initiated for 6 months where oral LP lesions resolved after 4 weeks also (with sporadic mild headache). Conclusion: Further studies are needed to better understand the impact of alitretinoin in LP. Our observation suggests alitretinoin as a new, well-tolerated treatment option for esophageal LP after failed response to conventional treatments.

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“…Dilation is commonly used despite concerns about worsening esophageal stenosis or oral lesions due to Koebner phenomenon. Other regimens described include adrenocorticotropic hormone injections, oral corticosteroids, etretinate, and topical corticosteroids 1,11–23 . Topical tacrolimus, a potent inactivator of T‐lymphocytes used initially in patients with transplants, was successful for oral lichen planus in six patients 24–26 Table 3.…”

Section: Treatmentmentioning

confidence: 99%

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

Keate

Williams

Connolly

2003

Diseases of the Esophagus

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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.

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Lichen Ruber Mucosae with Esophageal Involvement

Cited by 21 publications

References 0 publications

Lichen planus with Oesophageal Involvement

Lichen planus with Oesophageal Involvement

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

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

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