Angina bullosa hemorrhagica of the soft palate: a clinical study of 16 cases

Abstract

Angina bullosa hemorrhagica (ABH) is an oral mucosal blood blister that develops without blood dyscrasia or vesiculobullous disorder. Although a minor mucosal trauma has been suggested as a triggering factor for ABH, its etiopathogenesis, especially the causative role of systemic conditions, is largely unknown. We investigated the presence or absence of local factors as well as systemic background disease in 16 patients with ABH arising in the soft palate. All the lesions were solitary, and 75% of them (n = 12) appeared during the ingestion of hard or crispy food. With regard to underlying systemic conditions, hypertension was the most common (n = 6), and asthma, insomnia, diabetes mellitus, rheumatoid arthritis, gastrointestinal disorder and hyperuricemia were also recorded (n = 1 each). Five patients had no significant background disease. There were no recalcitrant or recurrent cases. In conclusion, the present study has revealed that scratching of the oral mucosa during eating plays an important role in the formation of ABH. Hypertension appears to be the most frequent background condition, but its pathogenic relationship with ABH remains speculative, as hypertension is fairly common in adults.

Angine bulleuse hémorragique après des soins dentaires : présentation d’un cas

“…Des affections systémiques sont parfois associées -lupus érythémateux disséminé [9], hypertension artérielle [12,14], thalassémie [13], diabète [3,12], insuffisance rénale chronique [12], rectocolite hémorragique -mais aucune relation causale n'a pu être établie. …”

“…De par sa définition [2], aucun trouble de l'hémostase n'a jamais été mis en évi-dence au cours des épisodes où la bulle se développe [4,8,9,13]. Dans de nombreux cas, l'apparition des bulles a pu être corrélée à des traumatismes locaux lors de l'alimentation, de soins dentaires, de traitements parodontaux ou dus à des prothèses dentaires iatrogènes [4,7,11,12,[14][15][16][17]. Un traumatisme initial est retrouvé dans 53 % des cas [4] ; pour les autres cas, l'apparition semble spontanée.…”

“…Horie et al [14], sans pouvoir établir de relation pathogé-nique, retrouve une prédominance de patients hypertendus dans un groupe de 16 patients ; Grinspan et al [3] 44% de patients diabétiques.…”

“…Le bilan biologique, indiqué seulement lorsqu'on suspecte un trouble de l'hémostase, ne révèle aucune anomalie [2,4,9,14].…”

Angina Bullosa Hemorrhagica: A Case Report

“…Other names to this lesion include benign bullosa hemorrhagic stomatitis and traumatic or recurrent oral hemophiltenosis. 3 Clinically, ABH is characterized by a single or multiple lesion, asymptomatic for their most part (but painful in some cases), appearing suddenly, 3,4 with color ranging from dark red to purple, which can break and expand rapidly in a term of 24 to 48 hours; 4 however, there are reports of cases lasting more than four months to years. 5 It may appear as multiple blisters of two to three centimeters in diameter that break spontaneously and heal leaving no scars, although may be recurrent.…”