Esophageal lichen planus:Current knowledge,challenges and future perspectives  

作　　者：Annegrit Decker Franziska Schauer Adhara Lazaro Carmen Monasterio Arthur Robert Schmidt Annette Schmitt-Graeff Wolfgang Kreisel 

机构地区：[1]Department of Medicine II,Gastroenterology,Hepatology,Endocrinology and Infectious Diseases,Medical Center-University of Freiburg,Faculty of Medicine,Freiburg 79106,Germany [2]Department of Dermatology,Medical Center-University of Freiburg,Faculty of Medicine,Freiburg 79104,Germany [3]Department of Medicine,Institute of Exercise and Occupational Medicine,Medical Center–University of Freiburg,Faculty of Medicine,University of Freiburg,Freiburg 79106,Germany [4]Institute for Dermatohistology,Pathology,and Molecular Pathology Prof.Dr.Laaf,Freiburg,Germany and:University of Freiburg,Freiburg 79106,Germany

出　　处：《World Journal of Gastroenterology》2022年第41期5893-5909,共17页世界胃肠病学杂志（英文版）

摘　　要：Lichen planus(LP)is a frequent,chronic inflammatory disease involving the skin,mucous membranes and/or skin appendages.Esophageal involvement in lichen planus(ELP)is a clinically important albeit underdiagnosed inflammatory condition.This narrative review aims to give an overview of the current knowledge on ELP,its prevalence,pathogenesis,clinical manifestation,diagnostic criteria,and therapeutic options in order to provide support in clinical management.Studies on ELP were collected using PubMed/Medline.Relevant clinical and therapeutical characteristics from published patient cohorts including our own cohort were extracted and summarized.ELP mainly affects middle-aged women.The principal symptom is dysphagia.However,asymptomatic cases despite progressed macroscopic esophageal lesions may occur.The pathogenesis is unknown,however an immune-mediated mechanism is probable.Endoscopically,ELP is characterized by mucosal denudation and tearing,trachealization,and hyperkeratosis.Scarring esophageal stenosis may occur in chronic courses.Histologic findings include mucosal detachment,T-lymphocytic infiltrations,epithelial apoptosis(Civatte bodies),dyskeratosis,and hyperkeratosis.Direct immuno-fluorescence shows fibrinogen deposits along the basement membrane zone.To date,there is no established therapy.However,treatment with topical steroids induces symptomatic and histologic improvement in two thirds of ELP patients in general.More severe cases may require therapy with immunosuppressors.In symptomatic esophageal stenosis,endoscopic dilation may be necessary.ELP may be regarded as a precancerous condition as transition to squamous cell carcinoma has been documented in literature.ELP is an underdiagnosed yet clinically important differential diagnosis for patients with unclear dysphagia or esophagitis.Timely diagnosis and therapy might prevent potential sequelae such as esophageal stenosis or development of invasive squamous cell carcinoma.Further studies are needed to gain more knowledge about the pathogenesis and treat

关 键 词：Lichen planus ESOPHAGITIS T-LYMPHOCYTES BUDESONIDE DYSPHAGIA Precancerosis 

分 类 号：R571[医药卫生—消化系统]