Evaluation and Management of Premalignant Conditions of the Esophagus: A Systematic Survey of International Guidelines

Esophageal Manifestations of Dermatological Diseases, Diagnosis and Management

Purpose of Review

The purpose of this article is to discuss the diagnosis and treatment of diseases that affect both the skin and the esophagus.

Recent Findings

The diagnosis of dermatological conditions that affect the esophagus often requires endoscopy and biopsy with some conditions requiring further investigation with serology, immunofluorescence, manometry, or genetic testing. Many conditions that affect the skin and esophagus can be treated successfully with systemic steroids and immunosuppressants including pemphigus, pemphigoid, HIV, esophageal lichen planus, and Crohn's disease. Many conditions are associated with esophageal strictures which are treated with endoscopic dilation. Furthermore, many of the diseases are pre-malignant and require vigilance and surveillance endoscopy.

Summary

Diseases that affect the skin and esophagus can be grouped by their underlying etiology: autoimmune (scleroderma, dermatomyositis, pemphigus, pemphigoid), infectious (herpes simplex virus, cytomegalovirus, human immunodeficiency virus), inflammatory (lichen planus and Crohn's disease), and genetic (epidermolysis bullosa, Cowden syndrome, focal dermal hypoplasia, and tylosis). It is important to consider primary skin conditions that affect the esophagus when patients present with dysphagia of unknown etiology and characteristic skin findings.

A protocol of systematic review and meta-analysis of narrow band imaging endoscopy in detection of early gastric cancer

BACKGROUND

Early gastric cancer is the fifth common malignancy and the third leading cause of cancer death throughout the world. However, it is not clear how endoscopic screening for early gastric cancer affects incidence or mortality. We performed a systematic review and meta-analysis to evaluate the relationship between endoscopic screening for the mortality and incidence of early gastric cancer.

MATERIALS AND METHODS

This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Web of Science, PubMed, EMBASE, and the Cochrane Library were searched for cohort and case-control studies in cases without early gastric cancer until March 31, 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the Eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The relative risk and 95% confidence intervals were used as effect estimate. I-square test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review.

RESULTS

The results will be published in a peer-reviewed journal.

CONCLUSION

The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also provide helpful evidence of whether endoscopic screening would reduce the mortality and incidence of early gastric cancer.

PROSPERO REGISTRATION NUMBER

CRD42020171053.