Effect of Azathioprine on Generalized Lichen Planus

Klein, Laura R.; Callen, Jeffrey P.

doi:10.1097/00007611-199009001-00049

Cited by 1 publication

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“…Cyclosporine has been used to treat genital LP (7). Antibacterial agents such as dapsone and immunosuppressants such as azathioprine have been used to treat only intractable cases of mucocutaneous LP (8,9). Unlike oral LP, esophageal LP cannot be treated with topical agents.…”

Section: Treatmentmentioning

confidence: 99%

Cyclosporine in the Management of Esophageal Lichen Planus

Chaklader

Morris-Larkin

Gulliver

et al. 2009

Canadian Journal of Gastroenterology

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Lichen planus (LP) is an uncommon disorder of unknown etiology, mostly affecting patients in their fifth and sixth decade of life. It is believed to be an autoimmune process involving T cells directed against basal keratinocytes. It affects the skin, nails, oral pharynx and genitals. Esophageal involvement is quite rare and can cause strictures, ulcerations and squamous cell cancer. The present article describes the case of a 54-year-old woman who was referred for assessment of dysphagia that initially occurred with solids, which then progressed to soft foods but spared liquids. The patient reported a weight loss of 9.1 kg. An esophagogastroduodenoscopy was performed and she was subsequently diagnosed with pill esophagitis. At the same time, she was also diagnosed with oral LP, with no involvement of the esophagus. She was treated with a proton pump inhibitor that resolved her gastrointestinal symptoms. The symptoms returned one year later and a repeat esophagogastroduodenoscopy revealed white plaques due to LP. She was treated with intermittent glucocorticoids. Diagnosis of esophageal LP is crucial for the proper treatment. Some patients may require systemic immunosuppression and mechanical dilation to prevent weight loss. Surveillance endoscopies should be performed to monitor for squamous cell cancer. Cyclosporine has been used for genital and oral LP, but the present case is the first in which it has been used successfully to treat esophageal LP.

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Section: Treatmentmentioning

confidence: 99%