Angina bullosa haemorrhagica

Author: Dr Mark Duffill, Hamilton, New Zealand, 2008

What is angina bullosa haemorrhagica?

Angina (painful), bullosa (a blister), haemorrhagica (blood-filled, American spelling hemorrhagica) describes a condition where an, often painful, tense, blood-filled blister or blisters develop in the mouth.

What are the symptoms of angina bullosa haemorrhagica?

The soft palate is the most common site. Other sites inside the mouth may be involved. There is usually a solitary lesion. Multiple blisters may develop. The blisters usually rupture spontaneously and the sites heal uneventfully

What is the cause of angina bullosa haemorrhagica?

Possible causative factors include trauma, long-term use of topical or inhaled steroids, diabetes and hereditary predilection.

Other conditions which may need consideration include mucous membrane pemphigoid, bullous pemphigoid, lichen planus, epidermolysis bullosa, dermatitis herpetiformis, linear IgA disease and oral amyloidosis.

Investigations

None are usually needed unless the above conditions need to be excluded. Skin antibodies may be measured. If a biopsy is taken in angina bullosa haemorrhagica, a blister will be found under the mucosa (lining of the mouth). This contains red blood cells and sparse inflammatory cells.

Management

No treatment is usually necessary other than a mild analgesic and/or a simple mouth wash.

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