Esophagitis dissecans superficialis in an HIV patient with a history of substance abuse

<title>Abstract</title> Esophagitis dissecans superficialis is a rare and often underdiagnosed entity, whose diagnosis relies on characteristic endoscopic findings. We present the case of a 58-year-old man with stage C3 human immunodeficiency virus (HIV) infection and a history of daily inhaled cannabis, cocaine, and heroin use. He was admitted with pneumococcal pneumonia, oropharyngeal candidiasis, and cachexia. Chest CT revealed thickening of the distal esophageal wall. Endoscopy demonstrated a circumferential desquamative and friable lesion consistent with superficial esophageal dissecans. Biopsies ruled out malignancy and viral infection. The compatible diagnosis was esophagitis dissecans superficialis, most likely secondary to chronic toxic substance use.