Symptomatic Improvement in Cicatricial Pemphigoid of the Trachea Achieved with Laser Ablation Bronchoscopy

Cicatricial Pemphigoid (CP) are a diverse group of subepithelial blistering disorders of the skin and mucous membranes. Here, we report the first case in which Nd:YAG laser (1064nm) laser ablation bronchoscopy was used to treat CP with tracheal involvement. Our patient is a 71-year-old male with a history of CP refractory to medical therapy affecting his trachea who presented with dyspnea. He initially underwent a fiberoptic bronchoscopy with piecemeal resection of his tracheal lesions, which mildly improved his symptoms. Next, he underwent bronchoscopy with Nd:YAG laser (1064nm) laser ablation. He was then entirely weaned off supplemental oxygen. For the following three months, he experienced a decreased symptomatic burden. A repeat laser ablation was planned, but due to interval changes in the patient’s airway anatomy, it was deemed unsafe. Consequently, the patient’s tracheal pemphigoid fully recurred. This case demonstrates the promise laser ablation holds for patients with tracheal cicatricial pemphigoid.