Esophageal lichen planus: Current knowledge, challenges and future perspectives.
Budesonide
Dysphagia
Esophagitis
Lichen planus
Precancerosis
T-lymphocytes
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
07 Nov 2022
07 Nov 2022
Historique:
received:
28
07
2022
revised:
17
09
2022
accepted:
27
10
2022
entrez:
21
11
2022
pubmed:
22
11
2022
medline:
23
11
2022
Statut:
ppublish
Résumé
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 treatment options.
Identifiants
pubmed: 36405107
doi: 10.3748/wjg.v28.i41.5893
pmc: PMC9669830
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
5893-5909Informations de copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Références
N Engl J Med. 2017 Nov 30;377(22):2167-2179
pubmed: 29171820
Exp Ther Med. 2019 Feb;17(2):1045-1051
pubmed: 30679972
N Engl J Med. 2020 Apr 30;382(18):1739-1748
pubmed: 32348645
ACG Case Rep J. 2016 Jan 20;3(2):98-100
pubmed: 26958558
N Engl J Med. 2012 Feb 23;366(8):723-32
pubmed: 22356325
Z Gastroenterol. 2021 May;59(5):460-469
pubmed: 33831967
J Oral Pathol Med. 2021 Mar;50(3):287-298
pubmed: 31981238
Int J Mol Sci. 2018 Feb 09;19(2):
pubmed: 29425183
Case Rep Dermatol. 2016 Aug 29;8(2):224-226
pubmed: 27721755
Inflamm Bowel Dis. 2015 Sep;21(9):2106-13
pubmed: 26083616
Indian J Dermatol Venereol Leprol. 2008 Sep-Oct;74(5):509-11
pubmed: 19052424
J Oral Pathol Med. 2011 Oct;40(9):677-83
pubmed: 21762430
Dysphagia. 2008 Sep;23(3):331-4
pubmed: 18575934
Arch Pathol Lab Med. 2008 Jun;132(6):1026-9
pubmed: 18517264
Scand J Gastroenterol. 2019 Oct;54(10):1189-1198
pubmed: 31608788
Cochrane Database Syst Rev. 2020 Feb 28;2:CD001168
pubmed: 32108333
ScientificWorldJournal. 2014 Jan 30;2014:742826
pubmed: 24672362
Am J Dermatopathol. 1982 Jun;4(3):267-9
pubmed: 7114412
Gastrointest Endosc. 2011 Sep;74(3):708-9
pubmed: 21092955
Gastrointest Endosc. 2006 Jan;63(1):168-9
pubmed: 16377342
N Engl J Med. 2021 Sep 30;385(14):1280-1291
pubmed: 34587385
World J Gastroenterol. 2013;19(14):2278-81
pubmed: 23599656
World J Gastroenterol. 2017 Feb 14;23(6):949-956
pubmed: 28246468
Endoscopy. 1988 Jul;20(4):158-60
pubmed: 3181088
Acta Derm Venereol. 2020 Oct 28;100(17):adv00303
pubmed: 33047145
Mod Pathol. 2017 Nov;30(11):1613-1621
pubmed: 28731047
Expert Rev Gastroenterol Hepatol. 2017 Jan;11(1):53-64
pubmed: 27835929
Clin Gastroenterol Hepatol. 2010 Sep;8(9):777-82
pubmed: 20471494
Am J Dermatopathol. 2018 Jul;40(7):491-497
pubmed: 29293127
J Gastroenterol. 2020 Jul;55(7):679-700
pubmed: 32377946
Clin Gastroenterol Hepatol. 2019 Feb;17(3):419-428.e6
pubmed: 29902648
BMJ. 1990 Jan 13;300(6717):84
pubmed: 2105780
Am J Surg Pathol. 2020 Feb;44(2):198-205
pubmed: 31651525
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):328-34
pubmed: 21782485
J Biomed Biotechnol. 2012;2012:589569
pubmed: 22888200
Semin Diagn Pathol. 2017 May;34(3):237-249
pubmed: 28396069
Biologics. 2021 Jun 29;15:247-253
pubmed: 34239295
Am J Gastroenterol. 2022 Jan 1;117(1):70-77
pubmed: 34591036
Int J Cancer. 2018 Jan 1;142(1):18-22
pubmed: 28857160
Clin Exp Dermatol. 1988 Jan;13(1):38-41
pubmed: 3208440
Expert Opin Ther Pat. 2022 Apr;32(4):365-379
pubmed: 35001782
Aliment Pharmacol Ther. 2022 Apr;55(7):789-804
pubmed: 35166398
Schweiz Med Wochenschr. 1994 Aug 20;124(33):1419-29
pubmed: 7939509
Oral Dis. 2018 Apr;24(3):377-383
pubmed: 28741807
Dig Dis Sci. 2015 Jul;60(7):2049-57
pubmed: 25701324
World J Gastrointest Endosc. 2010 Jul 16;2(7):252-6
pubmed: 21160615
J Investig Clin Dent. 2018 Nov;9(4):e12363
pubmed: 30270524
J Oral Pathol Med. 2019 Aug;48(7):552-559
pubmed: 31172572
Gastrointest Endosc. 1999 Aug;50(2):268-71
pubmed: 10425426
Case Rep Gastroenterol. 2015 Jul 22;9(2):253-60
pubmed: 26351413
Br J Dermatol. 2022 Nov;187(5):722-729
pubmed: 35819183
Clin Dermatol. 2001 Nov-Dec;19(6):703-11
pubmed: 11705679
Z Gastroenterol. 2012 Oct;50(10):1104-7
pubmed: 23059805
Am J Dermatopathol. 2009 Jul;31(5):509-10
pubmed: 19542934
Eur J Gastroenterol Hepatol. 2016 Dec;28(12):1374-1382
pubmed: 27580215
Mayo Clin Proc. 2017 Jun;92(6):965-972
pubmed: 28578784
Clin Gastroenterol Hepatol. 2017 Jun;15(6):937-944.e5
pubmed: 28065765
Adv Exp Med Biol. 2022;1367:119-135
pubmed: 35286694
Clin Gastroenterol Hepatol. 2017 Dec;15(12):1975-1977
pubmed: 28606847
Endoscopy. 2009 Mar;41(3):187-93
pubmed: 19280529
J Am Acad Dermatol. 2011 Jul;65(1):175-83
pubmed: 21536343
Clin Dermatol. 2015 Nov-Dec;33(6):631-43
pubmed: 26686015
Oral Dis. 2021 Jan 29;:
pubmed: 33512068
Dis Esophagus. 2003;16(1):47-53
pubmed: 12581256
Inflamm Bowel Dis. 2021 Nov 15;27(12):2023-2030
pubmed: 34089259
Semin Diagn Pathol. 2014 Mar;31(2):89-99
pubmed: 24815935
Dis Esophagus. 1999;12(4):309-11
pubmed: 10770369
J Dtsch Dermatol Ges. 2021 Jun;19(6):864-882
pubmed: 34096678
J Clin Exp Dent. 2018 Sep 01;10(9):e938-e944
pubmed: 30386529
J Eur Acad Dermatol Venereol. 2020 Jul;34(7):1403-1414
pubmed: 32678513
J Laryngol Otol. 1982 Jun;96(6):567-71
pubmed: 7086273
Gastroenterology. 2018 Oct;155(4):1022-1033.e10
pubmed: 30009819
Arch Dermatol. 2008 Nov;144(11):1427-30
pubmed: 19015416
Dermatology. 2013;226(4):302-10
pubmed: 23948733
Curr Opin Gastroenterol. 2012 Jul;28(4):382-8
pubmed: 22450900
Clin Oral Investig. 2022 Feb;26(2):1391-1408
pubmed: 34460001
Gastroenterology. 2014 Dec;147(6):1238-54
pubmed: 25109885
Gastroenterology. 2018 Jan;154(2):267-276
pubmed: 28780072
World J Gastroenterol. 2013 Mar 14;19(10):1652-6
pubmed: 23539434
Aliment Pharmacol Ther. 2022 Feb;55(3):277-291
pubmed: 34932238
Gut Liver. 2013 Jul;7(4):401-5
pubmed: 23898378
Dysphagia. 2021 Jun;36(3):504-516
pubmed: 33710389
Int J Biomed Sci. 2014 Dec;10(4):282-6
pubmed: 25598761
Am J Gastroenterol. 2013 Nov;108(11):1816-7
pubmed: 24192964
Dis Esophagus. 2011 May;24(4):211-4
pubmed: 20946136
Endoscopy. 2008 Sep;40(9):764-8
pubmed: 18535938
J Family Med Prim Care. 2019 Nov 15;8(11):3504-3517
pubmed: 31803644
Ir J Med Sci. 2015 Mar;184(1):75-6
pubmed: 24913736
Clin Gastroenterol Hepatol. 2022 Nov;20(11):2474-2484.e3
pubmed: 35181570
Dent Clin North Am. 2020 Jan;64(1):139-162
pubmed: 31735224
Med Oral Patol Oral Cir Bucal. 2010 Sep 01;15(5):e685-90
pubmed: 20383118
Mod Pathol. 2014 Jan;27(1):38-43
pubmed: 23765246
Clin Gastroenterol Hepatol. 2019 Mar;17(4):666-673.e8
pubmed: 29902649
Clin Gastroenterol Hepatol. 2019 Aug;17(9):1902-1903.e1
pubmed: 30342260
Curr Treat Options Gastroenterol. 2016 Mar;14(1):28-38
pubmed: 26847359
Gastrointest Endosc. 2014 Dec;80(6):960-9
pubmed: 25434655
J Clin Gastroenterol. 2009 Nov-Dec;43(10):915-9
pubmed: 19525865
Histopathology. 2021 Jan;78(1):4-17
pubmed: 33382498
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Sep;122(3):332-54
pubmed: 27401683
Mayo Clin Proc. 2020 Aug;95(8):1796
pubmed: 32753152
Immunotherapy. 2021 Sep;13(13):1135-1150
pubmed: 34235974
Gastroenterol Hepatol. 2013 Apr;36(4):264-7
pubmed: 23228815
Int J Dermatol. 2022 Feb;61(2):139-147
pubmed: 33929045
Aliment Pharmacol Ther. 2015 Jul;42(1):91-8
pubmed: 25963885
Oral Oncol. 2019 Sep;96:121-130
pubmed: 31422203
J Allergy Clin Immunol. 2021 Jun;147(6):2358-2369
pubmed: 33221382
JAMA Dermatol. 2020 Feb 1;156(2):172-181
pubmed: 31895418
Oral Dis. 2021 May;27(4):813-828
pubmed: 32144836
J Clin Pathol. 2017 Mar;70(3):208-216
pubmed: 27471274
Int J Womens Dermatol. 2015 Sep 16;1(3):140-149
pubmed: 28491978
Cancers (Basel). 2021 Nov 16;13(22):
pubmed: 34830892
Clin Rev Allergy Immunol. 2018 Dec;55(3):379-390
pubmed: 30109481
Aliment Pharmacol Ther. 2017 Jan;45(2):310-318
pubmed: 27859412
Gastroenterology. 2018 Jan;154(2):346-359
pubmed: 28756235
Front Immunol. 2019 Jul 02;10:1389
pubmed: 31312198