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Pemphigus is a rare autoimmune bullous disease which affects the mucous membranes and skin. Pemphigus vulgaris (PV) is the most prevalent type of pemphigus. PV presents with extremely painful, non-healing oral erosions. However, there are only a handful of reports addressing the pain management of PV. We would like to present a case of a painful PV, which was successfully managed.

Introduction: Interventions in pain management hold an important aspect in diagnosing as well as treating patients in today's practices. Knowing proper procedural technique is an important aspect for a pain practitioner to avoid complications. Each individual patient is not the same, thus producing a challenge for any pain intervention. In this article, we discuss the standard procedure of cervical epidural, contralateral interlaminar approach with its complications and troubleshooting.