Can you get lichen planus in the throat

The patient ultimately made a decision to undergo a minimally invasive esophagectomy for definitive management with acute and chronic inflammation seen on surgical pathology. Her symptoms significantly improved in the months following her surgery. However, she gradually developed symptoms of dysphagia, abdominal cramping, nausea, emesis, and weight loss. This was felt to be secondary to delayed gastric emptying and a mild anastomotic stricture. She underwent Botox injection into the pylorus along with therapeutic dilation and triamcinolone acetonide injection to stricture.

Her symptoms improved after these interventions. Dysphagia is the most common symptom and was the predominant complaint in this case [ 3 , 5 ]. Although some autoimmune diseases have been reported to be associated with LP [ 1 ], the reported coexisting diseases in ELP are limited in several reports. There has been though a noted increased history of thyroid disorders in ELP cases [ 2 ]. Although hepatitis C has been associated with LP, it is infrequent in ELP reports, consistent with our findings [ 2 , 3 ].

This is in contrast to reflux disease with distal involvement [ 2 ]. Macroscopic findings are nonspecific but include a friable mucosa, whitish papules, esophageal webs, and strictures that can be multiple in numbers [ 3 , 5 , 6 ].

Histopathology may be nondiagnostic in half of cases with interpretations of esophagitis or chronic inflammation. Findings that help support a diagnosis of ELP include a band-like lymphocytic infiltrate involving the superficial lamina propria and basal epithelium along with the presence of Civatte bodies [ 7 , 8 ]. Despite multiple biopsies in this case, a diagnosis of ELP was not suggested on histopathology until deep biopsies were performed. As in our case, reflux esophagitis is often initially suspected with initiation of PPI therapy leading to no improvement in strictures [ 4 ].

ELP is often a diagnostic challenge with a large series [ 3 ] showing a mean of nearly five years until diagnosis.

As a result, multiple endoscopies and dilations are often performed before reaching a diagnosis [ 3 , 4 ]. Treatment generally starts with oral glucocorticoid therapy. Though the majority of patients often respond to this approach, some may develop symptomatic recurrence during tapering and require longer therapy.

In addition, those who had complete response often have recurrence of disease later on highlighting the potential chronic and recurring nature of ELP [ 4 , 5 ]. Failure to respond is likely to occur for those with strictures at diagnosis as in our case [ 2 ]. Fluticasone propionate and intralesional triamcinolone acetate have also been utilized for improving symptoms [ 9 , 10 ].

Aside from glucocorticoids, limited reports have utilized tacrolimus including aqueous preparations and cyclosporine with reported good response [ 10 , 11 ]. Another aspect of treatment has been dilations for strictures in order to achieve immediate improvement in symptoms [ 5 , 12 ].

Some cases have demonstrated concern for inducing the Koebner phenomenon at sites of trauma with dilatation [ 4 ]. However, dilatations are often necessary in patients and are performed with concurrent therapy aimed at controlling the disease [ 3 ].

Moreover, some patients even with prolonged and multiple treatment strategies may not respond sufficiently resulting in frequent dilatation procedures [ 8 ]. Our patient had developed poor responses despite aggressive steroid therapies and dilations, ultimately leading to definitive surgical management.

Although it is not certain if LP itself is an independent risk for malignant conversions, there are cases of esophageal squamous cell cancer in those with ELP [ 3 , 5 , 13 , 14 ]. Therefore surveillance should be considered. Given the rarity of reported ELP, variable responses to treatment, and reports of malignancy, management may be better served utilizing a multidisciplinary approach.

In summary, clinicians should consider ELP in the differential for dysphagia, especially for middle- to elderly-aged females, with refractory stricturing disease and without typical GERD symptoms or failure to respond to antireflux management. Awareness of the clinical history along with improved recognition and reporting of characteristic histopathology of ELP may lead to an earlier diagnosis and optimize outcomes.

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Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors. Read the winning articles. Journal overview. Academic Editor: Tetsuo Hirata. Received 06 Jun Revised 20 Aug Accepted 30 Aug Published 04 Oct Some factors may increase your risk of developing oral lichen planus, such as having a disorder that lowers your immunity or taking certain medications, though more research is needed.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Oral lichen planus Open pop-up dialog box Close. Oral lichen planus This white lacelike patch on the interior surface of the cheek is typical for oral lichen planus. Request an Appointment at Mayo Clinic.

Share on: Facebook Twitter. Show references AskMayoExpert. Oral lichen planus. Mayo Clinic; Lichen planus. Merck Manual Professional Version. Accessed March 18, American Academy of Oral Medicine. March 18, Equal numbers of men and women get lichen planus of the skin, but women are twice as likely to get oral inside the mouth lichen planus. The disease is rare in people who are very young or very old.

Your doctor or dentist may diagnose lichen planus, based on the changes on your skin or in your mouth. To make sure of the diagnosis, your doctor will perform a biopsy. He or she will remove mouth mucosa, or a small piece of skin, and send it to be examined it under a microscope. If your biopsy shows lichen planus and you have no symptoms, you probably do not need treatment. In most cases, lichen planus will go away within 2 years. If you have symptoms, such as severe itching or sores in your mouth or genital area, treatment can help.

If you have lichen planus on your scalp, treatment is important to prevent permanent hair loss. Lichen planus has no cure, but different treatments can help relieve your symptoms and speed healing. Possible treatments include:.

Steroids on your skin or in your mouth to fight inflammation You may also take steroids in pill form for severe cases. Some evidence suggests that oral lichen planus may be an early warning for oral cancer. Make sure you see your dentist for an oral exam at least twice a year. If you have any symptoms of lichen planus, talk with your doctor.

You may need to see a dermatologist for the most effective care. For oral lichen planus, stop smoking, avoid alcohol, maintain good oral hygiene, and avoid any foods that seem to irritate your mouth. Lichen planus is not a dangerous disease, and it usually goes away on its own.