Desquamative esophagitis: a refractory mucosal injury pattern

Desquamative esophagitis is a pattern of mucosal injury that may be idiopathic or associated with a known disorder. Because of its low prevalence, there is little published literature regarding this type of injury. We retrospectively reviewed an electronic pathology database at the Mayo Clinic for all esophageal biopsies performed during 2007-2014 that were also submitted for immunofluorescence staining. Patients whose clinicopathologic features qualified for the diagnosis of desquamative esophagitis were included in the study. Twenty-five patients with desquamative esophagitis (20 women; mean age: 68 years) were included in the study. Nineteen patients had associated with immunodermatological diseases. The average number of esophagogastroduodenoscopies was 10. Twenty-one patients underwent endoscopic dilation with average of eight attempts for dilation. The majority of patients received partial or no symptomatic improvement from endoscopic treatment. Most patients who have desquamative esophagitis do not have an esophageal biopsy diagnostic for the underlying etiology, but they still require multiple endoscopic treatments.