Esophagitis dissecans superficialis (EDS): an unusual desquamative disorder of unknown etiology

A 62-year-old woman with a known allergy to beta-lactams and no other relevant history presented with pyrosis. Gastroscopy revealed extensive whitish sheets of detached superficial mucosa in the mid-esophagus, overlying an otherwise macroscopically normal mucosa. Esophageal biopsies revealed reactive squamous epithelium separated from the basement membrane with focal polymorphonuclear infiltration. Following intensified antisecretory treatment, the patient remained asymptomatic, and a follow-up endoscopy showed mucosal healing [1] [2].

This case is consistent with a diagnosis of esophagitis dissecans superficialis (EDS), confirmed by both endoscopic and histological findings. EDS is a rare disease within the group of desquamative esophagitis. Its etiology is mostly idiopathic, although pharmacological causes (bisphosphonates, NSAIDs, potassium chloride, doxycycline) and autoimmune causes (celiac disease, bullous dermatoses) have been linked to it. In this instance, the etiology remains unknown, with no pharmacological or autoimmune associations. The prognosis is favorable, with a tendency toward spontaneous resolution and complete healing. However, further extensive studies are needed to elucidate the etiopathogenesis of this condition.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Ollero Domenche L, Del Valle Sánchez ME, Abecia Martínez EI, Hörndler Argárate C.. Esofagitis disecante superficial: dos casos de una misma entidad poco frecuente [Esophagitis dissecans superficialis: two cases of the same rare entity] Rev Esp Patol. 2024; 57 (2) 133-136 Spanish doi:10.1016/j.patol.2023.11.002. Epub 2023 Dec 26. PMID: 38599734.
• 2 Fiani E, Guisset F, Fontanges Q, Devière J, Lemmers A.. Esophagitis dissecans superficialis : a case series of 7 patients and review of the literature. Acta Gastroenterol Belg 2017; 80 (3): 371-375 PMID: 29560665