S3276 Isolated Esophageal Lichen Planus: A Rare Cause of Persistent Dysphagia in an Elderly Woman
Abstract
Introduction: Lichen planus (LP) is an idiopathic, chronic inflammatory disorder commonly involving the skin and mucous membranes. Esophageal involvement, known as esophageal lichen planus (ELP), is a rare manifestation of LP typically presenting with progressive dysphagia. ELP can significantly impact a patient's quality of life because of its gradual onset and potential complications like esophageal strictures and mucosal damage. We report a rare case of isolated ELP in an elderly woman presenting with prolonged dysphagia, without cutaneous or anogenital LP, treated with budesonide. Case Description/Methods: A 74-year-old woman with a medical history of polymyalgia rheumatica (PMR) and non-Hodgkin’s lymphoma treated with chemotherapy presented with hoarseness and progressively worsening dysphagia to solids over the last 2 years. Despite 3 esophageal dilations, her dysphagia persisted and was associated with heartburn, regurgitation, and acid reflux, for which she took dexlansoprazole. The patient denied any history of tobacco use but had a family history of esophageal cancer in her brother. Laboratory results were unrevealing, and an evaluation by ENT was unremarkable. Further testing with a modified barium swallow revealed esophageal dysphagia with retention and retrograde flow below the upper esophageal sphincter (UES). An esophagogastroduodenoscopy (EGD) showed white, lacey, pale mucosa involving the entire esophagus, a finding consistent with known LP. Additionally, an…
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