Esophageal Stricture in Pemphigus or Pemphigoid Disease

When esophageal stricture arises in the setting of pemphigus or pemphigoid disease, the underlying autoimmune process affecting the esophageal mucosa drives the clinical picture. Management must target that root cause, not the stricture in isolation.

Clinical scenario: Esophageal stricture occurring as a consequence of pemphigus or pemphigoid disease directly involving the esophagus. Pemphigus is an autoimmune disorder in which autoantibodies target desmosomes, disrupting cell-to-cell adhesion and leading to blistering of the skin and mucous membranes — including the esophageal lining. Pemphigoid disease causes similar mucosal injury through related, though distinct, autoimmune mechanisms.

Treatment approach

The central aim is treating the underlying pemphigus or pemphigoid disease. This typically involves systemic steroids and immunotherapy — the specific agents, sequencing, and complete structured regimen are contained in the full protocol.

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References

DOI: 10.1016/j.giec.2025.02.002

Pemphigus is an autoimmune disorder caused by autoantibodies that target desmosomes, thereby compromising cell-to-cell adhesion, causing blistering of the skin and mucous membranes.

The treatment of pemphigus and pemphigoid disease affecting the esophagus involves treating the underlying disease, often with systemic steroids and immunotherapy.

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