PMC7204857_01
Esophagogastroduodenoscopy at admission revealing sloughing of large fragments of esophageal mucosa with black/brown pigmentation of esophageal mucosa.
crg-0014-0172-g01.jpg
PMC7204857_01_crg-0014-0172-g01.jpg
F1
EGD revealed sloughing of esophageal mucosa with blueish discoloration of submucosal layer, dilated esophagus with decreased contraction, and erosive areas of ulceration (Fig. 1).
Low-resolution image of esophageal biopsy with splitting of the squamous epithelium at different levels and basal layer hyperplasia (A), intraepithelial cystic degeneration with variably sized cysts and bullae (B), and black/brown Iron pigment in the basal layer and intraepithelial cystic degeneration (C).
crg-0014-0172-g02.jpg
PMC7204857_01_crg-0014-0172-g02.jpg
F2
Pathological analysis demonstrated vacuolar degeneration at the midlevel of the epithelium with overlying hyperkeratosis and parakeratosis, with noted black/brown pigment present at the level of the split in the epithelium (Fig. 2).
Esophagogastroduodenoscopy after treatment revealing resolution of black/brown pigmentation of esophageal mucosa with no evidence of esophagitis dissecans superficialis.
crg-0014-0172-g03.jpg
PMC7204857_01_crg-0014-0172-g03.jpg
F3
EGD was then repeated and showed a significant improvement in the esophageal mucosa and resolution of strictures and ulcerations (Fig. 3).