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Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 89  

Angina bullosa hemorrhagica

Department of Dermato-Venereo-Leprology, Government Medical College and Hospital, Nagpur, Maharashtra, India

Date of Web Publication14-Jan-2019

Correspondence Address:
Bhagyashree B Supekar
Department of Dermato-Venereo-Leprology, Government Medical College and Hospital, Nagpur, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_108_18

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How to cite this article:
Supekar BB, Sawatkar G, Wankhade VH. Angina bullosa hemorrhagica. Indian Dermatol Online J 2019;10:89

How to cite this URL:
Supekar BB, Sawatkar G, Wankhade VH. Angina bullosa hemorrhagica. Indian Dermatol Online J [serial online] 2019 [cited 2021 Dec 8];10:89. Available from: https://www.idoj.in/text.asp?2019/10/1/89/250060

A 48-year-old male, a known case of hypertension and diabetes mellitus, presented with asymptomatic, single blood-filled blister over labial mucosa. On examination, non tender hemorrhagic bulla of size 1.5–2 cm in diameter was present over the inner aspect of lower lip [Figure 1]. It ruptured spontaneously and healed within 7 days without any sequelae. Hematological and coagulation investigations were normal. Classical clinical morphology led to the diagnosis of angina bullosa hemorrhagica (ABH).
Figure 1: Single, well defined, nontender, haemorrahagic bulla over inner aspect of lower lip

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ABH, a term coined by Badham in 1967,[1] is a benign phenomenon, appearing as painless single or multiple blood-filled blisters over oropharyngeal mucosa. ABH usually affects the soft palate, but lesions may occur in the anterior pillar of the fauces, epiglottis, arytenoids, pharyngeal wall, and esophagus.[2] These lesions rupture spontaneously to form ragged, often painless, superficial erosions that heal spontaneously within 1 week without scarring. Known causes include trauma, hot-spicy foods, dental procedures, steroid inhalers, and systemic diseases such as diabetes-mellitus, hypertension, and chronic renal failure.[3],[4],[5] Overall, trauma has been found to the common cause. Differential diagnosis must include thrombocytopenia, pemphigus, bullous pemphigoid, bullous lichen planus, dermatitis herpetiformis, epidermolysis bullosa, and oral amyloidosis. Hematological investigations, biopsy, and immunofluorescence studies may be useful to exclude other causes of oral blisters. Diagnosis of ABH is essentially clinical and should not be confused with other severe chronic diseases of oral cavity. No treatment is required for ABH because the blood-filled blisters spontaneously rupture and heal.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Badham NJ. Blood blisters and the esophageal cast. J Laryngol Otol 1967;81:791-803.  Back to cited text no. 1
Giuliani M, Favia GF, Lajolo C, Miani CM. Angina bullosa haemorrhagica: Presentation of eight new cases and a review of the literature. Oral Dis 2002;8:54-8.  Back to cited text no. 2
Horie N, Kawano R, Inaba J. Angina bullosa hemorrhagica of the soft palate: A clinical study of 16 cases. J Oral Sci 2008;50:33-6.  Back to cited text no. 3
High AS, Main DM. Angina bullosa haemorrhagica: A complication of long-term steroid inhaler use. Br Dent J 1988;165:176-9.  Back to cited text no. 4
Yamamoto K, Fujimoto M, Inoue M, Maeda M, Yamakawa N, Kirita T. Angina bullosa hemorrhagica of the soft palate: Report of 11 cases and literature review. J Oral Maxillofac Surg 2006;64:1433-6.  Back to cited text no. 5


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