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Angina Bullosa Hemorrhagica

Background

Angina bullosa hemorrhagica (ABH) is the term used to describe acute, benign, and generally subepithelial oral mucosal blisters filled with blood that are not attributable to a systemic disorder or hemostatic defect.

This condition was first described in 1933 as traumatic oral hemophlyctenosis. Badham first used the currently accepted term angina bullosa hemorrhagica in 1967.

The lesions may be confused with other more serious disorders (eg, mucous membrane pemphigoid, epidermolysis bullosa, linear IgA, dermatitis herpetiformis); however, the isolated nature, rapid healing, and rare recurrence of angina bullosa hemorrhagica blisters generally are sufficient findings to rule out the previously mentioned conditions.

The lesions of angina bullosa hemorrhagica may be indistinguishable from blood blisters related to thrombocytopenia; however, blood tests and the absence of areas of ecchymosis, epistaxis, or gingival bleeding are helpful signs to rule it out.

Some authors suggest mild trauma as the causative agent in angina bullosa hemorrhagica to break the epithelial–connective-tissue junction, causing bleeding of superficial capillaries and resulting in the formation of a subepithelial hemorrhagic bullae.

Also see the Medscape articles Bullous Pemphigoid, Epidermolysis Bullosa, Linear IgA Dermatosis, and Dermatitis Herpetiformis.

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