Angina Bullosa Haemorrhagica

Introduction

Angina (painful), bullosa (blister), haemorrhagica (blood-filled) is a very rare and benign condition of the oral mucous membrane, characterized by the sudden appearance of blood-filled blister(s) within the oral cavity.

  • The first indication is a stinging pain or burning sensation just before the appearance of a blood blister.
  • The risk of recurrence is 30% and the blister may appear on the same or in another location.

Angina Bullosa Haemorrhagica



Causes

The exact mechanism of the disease is unclear, but probably multifactorial.

More than 50% of the cases are related to minor trauma caused by

  • Hot foods
  • Restorative dentistry (fillings, crowns, etc.)
  • Periodontal therapy
  • Anaesthetic dental injections



Treatment

The blisters usually rupture in a day or two and heal spontaneously without any further scarring or discomfort.

  • Blood tests may be carried out to rule out a blood disorder (e.g. thrombocytopenia, von Willebrand disease, leukaemia and some vasculitis)

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

  • Any discomfort may be eased by using a benzydamine mouthwash.
  • Chlorhexidine mouthwash may reduce any possible secondary infection and therefore aid healing.

In rare cases, if a large lesion located in the throat does not rupture spontaneously, it may lead to airway obstruction. An intubation or even a tracheotomy might be needed.



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