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Esophageal Lichen Planus and Development of Dysplasia

  • Alexandra L. Strauss
    Affiliations
    Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Danielle Fortuna
    Affiliations
    Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Gary W. Falk
    Correspondence
    Correspondence: Address correspondence to: Gary W. Falk, MD, MS, Division of Gastroenterology, Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, 7th Floor S Pavilion PCAM, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania 19104.
    Affiliations
    Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Open AccessPublished:August 07, 2022DOI:https://doi.org/10.1016/j.gastha.2022.07.021
      A 54-year-old woman with a 10-year history of esophageal lichen planus underwent an upper endoscopy because of a modest increase in dysphagia (Figure A). This revealed features of known lichen planus, including loss of normal vascular pattern and a whitish-lacy appearance without focal abnormalities, but random biopsies demonstrated high-grade dysplasia. For further evaluation, she underwent endoscopy with Lugol’s staining that revealed an area of focal nonstaining (Figure B), which was biopsied. Pathology again demonstrated high-grade dysplasia (Figure C). She then underwent endoscopic mucosal resection of the high-grade dysplasia (Figure D) with pathologic margins free of dysplasia and no evidence of invasive squamous cell carcinoma.

      Acknowledgments:

      The authors thank Gregory G. Ginsberg MD for providing endoscopic images.