What is a hallmark endoscopic feature of eosinophilic esophagitis?

• A. Linear furrows and concentric rings (crepe-paper esophagus) with possible white exudates
• B. Ulcerations throughout the esophagus
• C. Normal mucosa
• D. Strictures only

Answer: (A)

The hallmark endoscopic feature of eosinophilic esophagitis is the combination of linear furrows and concentric rings in the esophageal lining, often described as crepe-paper esophagus, and these may be accompanied by white exudates. These visible patterns come from chronic inflammation that causes edema and remodeling of the esophageal wall, leading to the ringed, corrugated appearance and the longitudinal furrows. White patches represent eosinophilic microabscesses on the mucosa and support the diagnosis when seen with the characteristic pattern. While ulcers, normal-appearing mucosa, or isolated strictures can occur in various conditions or in different stages of EoE, they do not define the classic endoscopic appearance.