(11) Oesophageal strictures in cicatricial pemphigoid

Abstract

Cicatricial pemphigoid is a rare disease affecting the skin and mucous membranes. It is a disorder characterized by sub-epidermal blisters which heal with fibrosis and scarring. The diagnosis is confirmed by demonstration of immunoglobulins along the basement membrane of perilesional tissue using immunofluorescence. Ten patients with cicatricial pemphigoid who complained of dysphagia were investigated by barium swallow. An upper oesophageal stricture was demonstrated in eight of these. In the remaining two patients indirect laryngoscopy showed hypopharyngeal ulcers which could account for the dysphagia. A benign stricture of the upper third of the oesophagus is a rare finding and cicatricial pemphigoid should be recognized as a possible cause. The other clinical manifestations of cicatricial pemphigoid may be subtle. However, they can be seen on careful examination of the skin and mucous membranes which will enable the diagnosis to be made.