Angina Bullosa Hemorrhagica: Frightening Experience-A Case Series

Abstract

Angina bullosa haemorrhagica (ABH) is characterized by the recurrent appearance of haemorrhagic bullae on the oropharyngeal mucosa which rupture spontaneously leading to complete recovery within a weeks' time without any scarring. We report the clinical features of six cases of ABH. A cross-sectional observational study was performed. A total of six cases of ABH fulfilling the Ordioni et. al. criteria for diagnosis of ABH were enrolled.The age of our patients were 65, 25, 20, 35, 55 and 48 years. Four of them were females (67%), whereas two were males (33%).Retromolar trigone involvement was most common.The chief complaint in all was reddish bulla(e) in the oral cavity of 1 day duration. Five of the patients had solitary lesions, while one had multiple lesions. The lesions measured from 1 to 3 cm in diameter. Complete blood counts and clotting factors were normal in all patients. All cases healed within a week's time. ABH is not a very common disorder encountered by ENT surgeons, dermatologists, general practitioners, and the lack of knowledge of its normal presentation can lead to unnecessary anxiety and incorrect treatment. The typical hemorrhagic bulla(e) usually erupt after eating hard, hot, or spicy food. These lesions heal spontaneously and treatment is not necessary except for reassurance and mild anxiololytics.

Keywords: Angina bullosa haemorrhagica; Coagulation profile; Oral mucosa blisters; Reassurance.

Fig. 1

Showing one ABH blisters on Uvula (Left side) and one on retromolar trigones(Right upper and lower pictures)

Fig. 2

Showing one ABH blisters on Hard palate (Left side picture), right upper one picture showing blister on retromolar trigone and right lower one showing multiple blisters on Hard and Soft Palate