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Surgery Today

, Volume 27, Issue 3, pp 234–237 | Cite as

Stenosis of the Esophagus in Cicatricial Pemphigoid Resolved by colon Interposition: Report of a Case

  • Zeno Popovici
  • Mircea Deac
  • Maria Rotaru
  • Petre Veştemeanu
  • Virgil Vărgatu
Case Reports

Abstract

We present herein the exceedingly uncommon case of a patient with cicatricial pemphigoid (CP) who gradually developed conjunctival, oral, and esophageal involvement. Despite long-term medical management with dapsone and disulone, the ocular lesions progressed to produce further scarring, which led to ankyloblepharon, symblepharon, and ultimately, blindness of the right eye. After a period of 5 years the patient developed a total esophageal stricture, intractable by dilation, necessitating esophageal reconstruction. The details of an original procedure using a continuous colic loop are described, highlighting the better tolerance of this technique by a high-risk patient. A discussion on the recent advances in diagnosing bullous dermatoses is presented following this case report.

Key Words

cicatricial pemphigoid esophageal stenosis coloesophagoplasty 

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References

  1. 1.
    Anderson HA, Sanderson DR (1974) Webs, rings and rare types of esophagitis. In: Payne WS, Olsen AM (eds) The esophagus. Lea and Febiger, Philadelphia, pp 155–157Google Scholar
  2. 2.
    Lever WF (1965) Pemphigus and pemphigoid. Thomas, SpringfieldGoogle Scholar
  3. 3.
    Raque CJ, Stein KM, Samitz MH (1970) Pemphigus vuigaris involving the esophagus. Arch Dermatol 102:371–373Google Scholar
  4. 4.
    Triglianos A (1970) Pemphigus et sténose de l'oesophage. Ann Otolaryngol Chir Cervicofac 87:633–667Google Scholar
  5. 5.
    Mutasim DF, Nancy JP, Anhalt GJ (1993) Cicatricial pemphigoid. Dermatol Clin 11:499–510Google Scholar
  6. 6.
    Benedict EB, Lever WF (1952) Stenosis of the esophagus in benign mucous membrane pemphigus. Ann Otol Rhinol Laryngol 61:1120–1132Google Scholar
  7. 7.
    Foroozan P, Enta T, Winship DH, Trier JS (1967) Loss and regeneration of the esophageal mucosa in pemphigoid. Gastroenterology 52:548Google Scholar
  8. 8.
    Johnson ML (1976) Epidermolysis bullosa acquisita with esophageal casts. Proc R Soc Med 60:1272Google Scholar
  9. 9.
    Hardy KM, Perry HO, Pingree GC (1971) Benign mucous membrane pemphigoid. Arch Dermatol 104:467–475Google Scholar
  10. 10.
    Shklar G, McCarthy PL (1971) Oral lesions of mucous membrane pemphigoid: a study of 85 cases. Arch Otolaryngol 93:354–364Google Scholar
  11. 11.
    Agha FP, Francis IR, Ellis CN (1983) Esophageal involvement in epidermolysis bullosa dystrophica: clinical and radiographic manifestations. Gastrointestinal Radiol 8:111–117Google Scholar
  12. 12.
    Popovici Z (1991) Esophageal injuries. In: Webb WR, Besson A (eds) International trends in general thoracic surgery, vol. 7 Mosby Year Book, St. Louis, pp 443–468Google Scholar
  13. 13.
    Popovici Z (1992) Pharyngeal-oesophageal reconstruction with laryngeal preservation following severe caustic injury to the pharynx and oesophagus. In: Hennessy TPJ, Cuschieri A (eds) Surgery of the oesophagus, 2nd edn. Butterworth-Heinemann, Oxford, pp 328–349Google Scholar
  14. 14.
    Popovici Z (1989) About reconstruction of the pharynx with colon in extensive corrosive strictures. Kurume med J 36:41–47Google Scholar
  15. 15.
    Brunsting LA, Perry HO (1957) Benign pemphigoid? A report of seven cases with chronic, scarring, herpetiform plaques about the head and neck. Arch Dermatol 75:489Google Scholar
  16. 16.
    Eisen AZ (1969) Human skin collagenase: relationship to the pathogenesis of epidermolysis bullosa dystrophica. J Invest Dermatol 52:449–453Google Scholar
  17. 17.
    Gedde-Dahl Jr T (1971) Epidermolysis bullosa: a clinical, genetic and epidemiological study. Johns Hopkins University Press, BaltimoreGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Zeno Popovici
    • 1
  • Mircea Deac
    • 1
  • Maria Rotaru
    • 1
  • Petre Veştemeanu
    • 1
  • Virgil Vărgatu
    • 1
  1. 1.First Surgical ClinicFaculty of Medicine of SibiuSibiuRomania

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