A 29-year-old man with a history of reactive airway disease and eczema presented to the clinic with progressive odynophagia, hoarseness, and dysphagia of solids, liquids, and secretions for the past 6 months. There were no respiratory symptoms, and results of a complete head and neck physical examination were unremarkable. Flexible nasolaryngoscopy was performed and revealed erythema and swelling to the right arytenoid. A 2-week course of doxycycline was completed for presumed infectious supraglottitis without a change in symptoms. A biopsy and culture of the lesion was then collected in the office and revealed inflammatory disease but ultimately was nondiagnostic. The patient chose observation vs further workup at that time.