Eosinophilic Esophagitis Presenting as Complete Esophageal Desquamation: An Unusual Case of Chest Pain

The diagnosis of eosinophilic esophagitis has been steadily increasing with the increase usage of endoscopy as a diagnostic tool.  Here we present a case of complete esophageal desquamation visualized on endoscopy without any evidence of caustic ingestion or any other potential disease process that would cause a similar presentation.  The diagnosis of eosinophilic esophagitis was established by significantly increased intraepithelial eosinophils, eosinphilic micro-abscess and partially detached squamous epithelium on the esophageal biopsy. There was complete resolution of symptoms with standard therapy for eosinophilic esophagitis. To the best our knowledge, this is the first reported case in the English literature of eosinophilic esophagitis that presents as complete esophageal desquamation.