reported, with an estimated minimum prevalence of 4.9%. 1 Although BP patients with laryngeal lesions are usually asymptomatic, they can present with hoarseness, stridor, with or without dyspnea in severe cases. 4 We were unable to find previous reports of cases of BP that presented with acute progressive laryngeal involvement requiring emergency tracheostomy. The supraglottis is the most commonly affected laryngeal site in the pemphigoid. Erythematous and edematous laryngeal mucosa with multiple erosions were observed on fiber-optic laryngoscopy. Imaging tests, such as computed tomography, are also needed to evaluate the extent of the disease and assist in the differential diagnosis. An initial airway evaluation using fiber-optic laryngoscopy is required to determine whether a tracheostomy is necessary. Early and aggressive systemic treatment is necessary to prevent airway stenosis and obstruction in BP with laryngeal involvement.Therefore, management with systemic corticosteroids is recommended, with close follow-up to monitor the resolution of laryngeal lesions.In summary, we report a case of BP with laryngeal involvement that presented with critical airway narrowing, requiring emergency tracheostomy. Laryngeal involvement in patients with BP can result in life-threatening airway stenosis and obstruction. BP patients with suspected laryngeal involvement should be promptly evaluated by an otolaryngologist. Although rare, dermatologists should be aware of this since it is a potentially severe complication of BP.

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