Pemphigus is a rare autoimmune blistering disease that typically starts in the skin or mouth but can also affect the throat and voice box. When it involves the larynx, it can cause painful sores, hoarseness, coughing, throat bleeding, and even scar tissue that narrows the airway. Related diseases include pemphigoid and cicatricial pemphigoid, which can also cause mucosal scarring in the throat. Pemphigus is usually managed with oral or intravenous steroids, and immune-suppressing medications coordinated with a dermatologist or rheumatologist. In our office, we help manage airway symptoms with CO2 laser treatment, injections, or dilation to open any scarred areas. If airway narrowing becomes severe, we may recommend surgery or, in rare cases, a tracheostomy.