Angina bullosa haemorrhagica

Angina Bullosa Haemorrhagica (ABH) is a rare, benign disorder characterized by the sudden appearance of blood-filled blisters (bullae) in the oral mucosa that are not attributable to a systemic disease or hemostatic disorder. Despite its alarming presentation, ABH is generally painless and resolves without intervention. The etiology of ABH remains largely idiopathic, though certain predisposing factors have been identified.

Etiology and Pathogenesis

The exact cause of ABH is unknown, but it is thought to result from minor trauma or injury to the oral mucosa, leading to the formation of blood blisters. These injuries may be due to dental procedures, aggressive tooth brushing, or even hot or spicy foods. In some cases, the use of inhaled corticosteroids has been implicated. Despite the association with these factors, the pathogenesis of ABH remains poorly understood.

Clinical Presentation

Patients with ABH typically present with a sudden onset of oral blisters. These blisters are filled with blood and can appear on any mucosal surface, though the soft palate is most commonly affected. The blisters are usually painless and burst within a few days, leaving a superficial erosion that heals without scarring.

Diagnosis

The diagnosis of ABH is primarily clinical, based on the characteristic appearance of the lesions and the absence of systemic disease. Laboratory tests are generally not necessary but may be performed to rule out other conditions with similar presentations, such as pemphigus vulgaris or mucous membrane pemphigoid.

Management

Treatment of ABH is largely supportive. Patients are advised to maintain good oral hygiene and avoid known triggers, such as hot or spicy foods. In cases where a specific trigger is identified, such as the use of inhaled corticosteroids, alternative medications may be considered. Lesions typically resolve spontaneously without the need for intervention.

Prognosis

The prognosis for ABH is excellent, with lesions healing without complication. However, recurrence is common, and patients may experience multiple episodes throughout their lifetime.

Epidemiology

ABH is a rare condition, and its exact prevalence is unknown. It can occur in individuals of any age but is most commonly reported in middle-aged adults. There is no known gender predilection.

Conclusion

Angina Bullosa Haemorrhagica is a benign, self-limiting condition characterized by the sudden appearance of blood-filled blisters in the oral mucosa. While its etiology remains unclear, it is associated with minor trauma and certain medications. Management is supportive, and the prognosis is favorable.