Case report and review of esophageal lichen planus treated with fluticasone

Table 1 Differentiation between types of lichen planus

	Cutaneous	Oral	Esophageal
Age and gender distribution	No gender preference	No gender preference	Generally middle aged females1
Clinical findings	Eruptions of violaceous, scaling, pruritic plaques[7]	Atrophic lesions, erosions, lace-like reticulated plaques[2]	Elevated lacy white papules, esophageal webs, pseudomembranes, desquamation, and superficial pinpoint erosions with and without stenosis[4,5,15,22-25]
Duration of illness	Self-limited with spontaneous regression in 1-2 yr[21]	Propensity for chronicity[7]	Propensity for chronicity[7]
Histologic findings	Hypergranulosis, hyperorthokeratosis, acanthosis and “saw-tooth” elongation of the rete pegs[21]	Oral lesions closely resemble esophageal lesions	Parakeratosis, atrophic epithelium, lacks hypergranulosis, variable thinning or acanthosis[21]
	Typical band-like inflammatory infiltrate with a predominance of mature T cells and basal layer degeneration including characteristic Civatte bodies (i.e., apoptotic basal keratinocytes)[21]	Typical band-like inflammatory infiltrate with a predominance of mature T cells and basal layer degeneration including characteristic Civatte bodies (i.e., apoptotic basal keratinocytes)[21]	Typical band-like inflammatory infiltrate with a predominance of mature T cells and basal layer degeneration including characteristic Civatte bodies (i.e., apoptotic basal keratinocytes)[21]
Risk of malignancy	No increased risk of malignant transformation	Increased risk of oral malignancy; Associated with hepatitis C	Some case reports have shown malignancy associated with esophageal lichen planus

¹One report by Chryssostalis et al[10] showed esophageal lichen planus in a 22-yr-old male patient.