A case of unusual presentation of stridor by laryngeal pemphigus

Pemphigus is an uncommon condition of mucosal and dermatological manifestations. Isolated laryngeal pemphigus without skin lesions is extremely rare. Supraglottic lesions are common in laryngeal pemphigus. Laryngeal manifestations may vary from simple hoarseness, throat pain, dysphagia to severe edema causing airway obstruction. This may necessitate tracheostomy. Laryngeal pemphigus with stridor is an extremely rare presentation. A 57-year-old gentleman, presented to emergency room with stridor. To secure the air way an emergency tracheostomy was done, followed by direct laryngoscopy and biopsy under anesthesia. A suspicion of laryngeal malignancy was made clinically. But to our surprise histopathology revealed pemphigus. Dermatologist opinion was taken and the patient was treated accordingly. He had very good response and was decannulated. Patient was followed regularly.