Question: A 68-year-old woman with a past medical history of asthma and vulvar lichen planus is referred to us for symptoms of dysphagia. Her dysphagia is to solids only. Symptoms started 1 year before presentation and have been progressive in nature. There was no associated odynophagia, regurgitation, unintentional weight loss, melena, or hematochezia. She has mild symptoms of gastroesophageal reflux disease that are well controlled with once daily proton pump inhibitor therapy. Her medications include daily maximum dose inhaled steroids for asthma.