Table 1: A summary of all 30 cases with esophagitis dissecans superficialis (EDS).

PatientGender/age (year)RacePresentationDiagnosis and associated conditionEndoscopic findingHistologyTreatmentOutcome

1 [8]F/81CanadianChronic intermittent dysphagiaNo significanceA thin white membrane lifting from mucosaMild candidal esophagitis; splitting of squamous mucosa at suprabasal and superficial layers; focal lymphocytic infiltration at deepest surfaces and diffuse parakeratosisDouble dose of PPIImprovement
2 [9]M/51NAIntermittent heartburn, anorexia, and epigastric pain without dysphagiaNSAID useA thin white membrane lifting from mucosa with necrotic zones located on the lower esophagusDetached superficial strips of squamous epithelium; prominent parakeratosis; acute inflammation and spongiosis in deep layers of squamous epitheliumDouble dose of PPIEndoscopic resolution 2 weeks after treatment
3 [10]F/76BelgianWeight loss and nauseaCOPD, CABG, hypertensionFibrotic and sclerotic aspect of distal third of the esophagusSloughing of superficial layer of esophageal epithelium; presence of eosinophils on surfaceNoImprovement
4 [10]F/70BelgianEpigastric painGastric bypassWhite pseudomembranes of mid and distal third of the esophagusSloughing of superficial layer of esophageal epithelium; presence of PMN on surface separating it from basal layerNoNA
5 [10]F/71BelgianEpigastric painArthrodesis L5-S1Elevated lesion of distal third of the esophagusSloughing of superficial layer of esophageal epithelium; presence of eosinophils on surfaceNoImprovement
6 [10]F/47BelgianDysphagiaGastrectomy with eso-jejunal anastomosis, hypothyroidism, autoimmune pancreatitisSloughed esophageal mucosa in the esophagusSloughing of superficial layer of esophageal epithelium; presence of a few bacterial colonies on surfaceNoImprovement
7 [10]F/77BelgianEpigastric painHypertension, hypercholesterolemia, hepatitis C, OSASloughing of esophageal mucosa in the distal two-third esophagusSloughing of superficial layer of esophageal epithelium separated from normal basal layerNoImprovement
8 [10]M/86BelgianAtypical chest painHypertension, hyperuricemiaGrade A reflux esophagitisSloughing of superficial layer of esophageal epithelium separated from normal basal layerNoNA
9 [10]F/83BelgianDysphagiaHypertension hypothyroidism, Alzheimer disease, DVTSuspicion of an esophageal tumor from 16 to 24 cm of dental arch, circumferential from 18 to 20 cmSloughing of superficial layer of esophageal epithelium, presence of PMN on surface separating it from basal layerNoImprovement
10 [7]F/42PortugueseDysphagiaType 1 diabetes mellitus, clindamycin treatment for diabetic footSloughing reddish membranes in the distal esophagus, adjacent to intact easily removed mucosaSquamous epithelium detached from underlying basal layer; preservation of remaining layers; mild parakeratosis; severe acute inflammation with some eosinophilsDouble dose of PPIImprovement
11 [5]F/59USADysphagia and odynophagiaHypersensitivity pneumonitis, bisphosphonateSloughing whitish membranes that were easily removed, adjacent to intact healthy mucosaParakeratosis and desquamation of epithelial layerBisphosphonate discontinuationImprovement
12 [4]M/46CaucasianNausea, vomiting, regurgitationHypertension, NSAID useDistinct features of denuded mucosal lining, stripped off mucosa, long mucosal breaks, linear furrows, and vertical fissuresFragments of superficial epithelium, parakeratosis; coagulative necrosis with epithelial sloughingDouble dose of PPI; NSAID discontinuationImprovement
13 [4]F/42CaucasianDysphagia, regurgitationGERDDistinct features of denuded mucosal lining, stripped off mucosa, long mucosal breaks, linear furrows, and vertical fissuresFragments of superficial epithelium, parakeratosis; coagulative necrosis with epithelial sloughingSingle dose of PPIImprovement
14 [4]F/79African AmericanDysphagia, nausea, vomitingGERD, bullous pemphigoid, diabetesDistinct features of denuded mucosal lining, stripped off mucosa, long mucosal breaks, linear furrows, and vertical fissuresFragments of superficial epithelium, parakeratosis; coagulative necrosis with epithelial sloughingSingle dose of PPIImprovement
15 [4]F/46African AmericanDysphagia, dyspepsiaGERD, hypertension, diabetesDistinct features of denuded mucosal lining, stripped off mucosa, long mucosal breaks, linear furrows, vertical fissuresFragments of superficial epithelium, parakeratosis; coagulative necrosis with epithelial sloughingDouble dose of PPIImprovement
16 [4]F/55HispanicHeartburnGERD, hypertension, NSAID useDistinct features of denuded mucosal lining, stripped off mucosa, long mucosal breaks, linear furrows, and vertical fissuresFragments of superficial epithelium, parakeratosis; coagulative necrosis with epithelial sloughingSingle dose of PPI; NSAID discontinuationImprovement
17 [1]M/61WhiteDysphagiaNADiffuse erythema, patches of peeling mucosa in the mid to distal esophagusParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPIImprovement
18 [1]M/81African AmericanUGIBNAMultiple patches of peeling mucosaParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPIImprovement
19 [1]M/77African AmericanWeight lossNADistal 2 cm patch of peeling mucosaParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
20 [1]M/65WhiteDysphagiaNAGrade 4 esophagitisParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPIImprovement
21 [1]M/60African AmericanUGIBNAGrade 3 esophagitis from the mid to distal esophagusParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPIImprovement
22 [1]M/57African AmericanEpigastric painNADistal multiple patches of peeling mucosaParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
23 [1]F/49WhiteHeartburnNAMid to distal grade 3 esophagitis, achalasiaParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPIImprovement
24 [1]M/65WhiteAnemiaNAMid to distal grade 4 esophagitisParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
25 [1]M/80WhiteIron deficiency anemiaNAMid to distal grade 4 esophagitisParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
26 [1]M/84WhiteUGIBNASloughing of entire esophagusParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
27 [1]M/63WhiteDysphagiaNAMultiple patches of peeling mucosa in the mid to distal esophagusParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
28 [1]M/84WhiteWeight lossNADistal adherent yellow patches of peeling mucosaParakeratosis; fragments of necrotic epithelium with minimal inflammation; intraepithelial splitting at varying degrees above basal layerDouble dose of PPINA
29 [11]F/88USAUGIBAtrial fibrillation, mitral regurgitation, post-cardiac arrest syndromeWhite, linear, desquamating plaques in the distal esophagusSloughing of superficial layer of esophageal epithelium; presence of eosinophils on surface; parakeratosisNoImprovement
30 (our case)M/50ThaiDysphagiaHIV infection, myasthenia gravisCircumferential white exudates with focal areas of erosions at the lower one-third esophagus without luminal stenosis or obstructionFoci of splitting of the squamous epithelium with few intraepithelial cystic degeneration; no parakeratosis; no basal cell hyperplasia; mild acute and chronic inflammatory infiltrates with focal squamous cell hyperplasia; and normal underlying mucosaDouble dose of PPIImprovement

COPD: chronic obstructive pulmonary disease; CABG: coronary artery bypass graft; OSA: obstructive sleep apnea; DVT: deep vein thrombosis; UGIB: upper gastrointestinal bleeding; PMN: polymorphonuclear cell; PPI: proton-pump inhibitor; NSAID: nonsteroidal anti-inflammatory drug.