Desquamating Esophagitis in the Era of Immune Checkpoint Inhibitors: A Rare Upper Gastrointestinal Manifestation

Desquamating esophagitis is a rare sloughing disorder of the esophageal mucosa most commonly associated with medications, autoimmune disease, or mucosal injury. Immune checkpoint inhibitors rarely cause esophageal involvement. We report a case of a 65-year-old woman with metastatic cervical cancer who developed progressive dysphagia 3 months after initiation of pembrolizumab. Endoscopy revealed severe proximal stenosis associated with desquamating esophagitis. She required frequent dilations but demonstrated marked and durable resolution after systemic corticosteroid therapy. This case highlights desquamating esophagitis as an uncommon immune-related adverse event and emphasizes that timely immunosuppression can reverse refractory inflammatory stricture.