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A 57-year-old woman presented to the Gastrointestinal Department with recurrent odynophagia and dysphagia for about 5 years. She also reported a 5-year history of oral soreness and multiple chronic oral ulcers, which were empirically diagnosed with lichen planus without biopsy in a local hospital and treated with steroids intermittently. She underwent upper gastrointestinal endoscopy three times during the last 5 years. Each endoscopy revealed mild stricture in the upper oesophagus with erosions or erythema. Histology results showed mainly inflammation. She was treated for Helicobacter pylori eradication and prescribed with proton pump inhibitors, but her symptoms remained. The physical examination was unremarkable except for mild oral erosions. Her skin was intact, without apparent lesions. Upper gastrointestinal endoscopy was performed again in our hospital, which revealed a whitish mucosa with mild stricture in the proximal third of the oesophagus (figure 1A–B). Stripping of the mucosa on withdrawal of the biopsy forceps was noticed (figure 1C). Serum antibodies for desmoglein 1 and 3 were both negative. Serum ELISA for anti-BP180 or anti-BP230 was negative. Histopathological examination (figure 1D) and direct immunofluorescence (DIF) of the oesophageal mucosa were performed (figure 1E).