Question: A 67-year-old woman with lichen planus involving the skin was referred for evaluation of progressive solid food dysphagia for 10 years. There was a documented 10-lbs weight loss in the last 3 months. She described an increase in frequency of meats and breads sticking in the substernal area requiring liquids to facilitate food bolus passage. She had undergone annual upper endoscopies for >10 years that showed erosive esophagitis and esophageal candidiasis. A distal esophageal luminal stenosis was seen on several occasions.