Angina Bullosa Haemorrhagica: Symptoms, and Treatment

Written by Medicover Team and Medically Reviewed by Dr Neha A Padia , ENT

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Angina Bullosa Haemorrhagica (ABH) is a relatively rare, benign condition characterized by sudden blood-filled blisters in the oral cavity. While it might sound alarming, understanding the symptoms, causes, and management options is crucial for effective treatment and prevention.

ABH manifests as blood-filled blisters, primarily on the soft palate, but can also occur on other oral mucosal surfaces. These blisters can develop spontaneously and rupture, often resulting in minor discomfort or a burning sensation. Despite their dramatic appearance, these lesions usually heal without scarring within a week.

What Are the Common Symptoms of Angina Bullosa Haemorrhagica?

Recognizing the symptoms of ABH is the first step in managing the condition. The primary symptom is the abrupt appearance of blood-filled blisters in the mouth. Here's a detailed overview of the symptoms:

Blister Formation: Sudden onset of blood-filled blisters, predominantly on the soft palate.
Size and Number: Blisters can vary in size and are often singular, though multiple blisters can occur.
Pain and Discomfort: Mild discomfort or burning sensation may accompany blister formation.
Self-Limiting Nature: Lesions typically resolve spontaneously without intervention within a week.

What Are the Common Causes Of Angina Bullosa Haemorrhagica?

Despite extensive research, the exact etiology of ABH remains unclear. However, several factors have been implicated in its development:

Mechanical Trauma

Mechanical trauma, such as sharp food or dental procedures, is frequently associated with the onset of ABH. The delicate mucosal tissue in the oral cavity is particularly susceptible to injury, which can precipitate blister formation.

Other Contributing Factors

Medications: Certain medications, particularly those that induce xerostomia (dry mouth), may contribute to ABH by reducing the protective salivary barrier.
Systemic Conditions: Although ABH is not directly linked to systemic diseases, underlying conditions such as diabetes or hypertension may exacerbate the susceptibility of oral tissues to trauma.
Aging: The incidence of ABH tends to increase with age, possibly due to the cumulative exposure to risk factors over time.

When to See a Doctor for Angina Bullosa Haemorrhagica?

While most blood blisters from Angina Bullosa Haemorrhagica resolve on their own, certain symptoms may affect your daily life or signal complications requiring prompt evaluation by an ENT doctor, Oral Medicine Specialist or Dermatologist.

You should see a doctor if you have:

Recurring blood blisters in the mouth appearing frequently without any obvious cause or trauma.
Blisters that are unusually large, painful, or interfering with eating, swallowing, or speaking.
Slow-healing sores or lesions that persist beyond two weeks after the blister ruptures.

Get medical help immediately if:

A large blister suddenly ruptures and causes significant bleeding that does not stop on its own.
You experience difficulty breathing or swallowing due to swelling from a blister in the throat area.
The affected area shows signs of infection, such as spreading redness, pus, or fever.

These could be signs of a serious complication like Angina Bullosa Haemorrhagica, which needs urgent care.

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How is the Diagnosis of Angina Bullosa Haemorrhagica Done?

Diagnosing ABH can be challenging due to its resemblance to other oral mucosal conditions. A thorough clinical examination is paramount, and a detailed medical history can aid in differentiating ABH from other disorders such as pemphigoid or pemphigus vulgaris.

Diagnostic Techniques

Clinical Examination: Visual inspection of the oral cavity for characteristic blood-filled blisters.
Histopathological Analysis: In rare cases, a biopsy may be performed to rule out other vesiculobullous diseases.
Exclusion of Other Conditions: Ensuring the absence of systemic symptoms or lesions elsewhere in the body helps confirm the diagnosis of ABH.

What Are The Treatment Options for Angina Bullosa Haemorrhagica

Given the self-limiting nature of ABH, treatment primarily focuses on symptom relief and preventing further trauma to the affected area.

Symptomatic Management

Pain Relief: Over-the-counter analgesics can help alleviate discomfort associated with blister formation.
Topical Treatments: Application of soothing agents such as aloe vera gel may provide symptomatic relief.
Dietary Modifications: Soft, bland foods are recommended to minimize mechanical irritation.

Preventive Measures

Avoidance of Triggers: Identifying and avoiding known triggers, such as sharp or hot foods, can reduce the risk of blister formation.
Oral Hygiene: Maintaining good oral hygiene and regular dental check-ups can help prevent trauma to the oral mucosa.

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Complications and Management of Angina Bullosa Haemorrhagica

While ABH is generally benign, complications can arise if blisters rupture and lead to secondary infections or if they interfere with breathing or swallowing.

Potential Complications

Infection: Ruptured blisters can become infected, necessitating antimicrobial therapy.
Airway Obstruction: Although rare, large blisters on the soft palate can compromise the airway, requiring immediate medical attention.

Long-Term Management

Monitoring: Regular monitoring of the condition helps in early detection of any significant changes.
Lifestyle Adjustments: Adopting a lifestyle that minimizes risk factors, such as smoking cessation, may reduce recurrence.

Frequently Asked Questions

1. What are the symptoms of Angina Bullosa Haemorrhagica?

Symptoms include sudden, blood-filled blisters in the mouth, usually on the soft palate, which may rupture, causing mild pain, bleeding, or difficulty swallowing.

2. What causes Angina Bullosa Haemorrhagica?

The exact cause is unknown, but it is often triggered by minor trauma to the mouth, hot foods, dental procedures, or the use of inhaled corticosteroids.

3. How is Angina Bullosa Haemorrhagica diagnosed?

Diagnosis is based on clinical examination, medical history, and, if necessary, blood tests or a biopsy to exclude other blistering disorders.

4. What treatment options are available for Angina Bullosa Haemorrhagica?

Treatment is usually supportive and includes antiseptic mouth rinses, pain relief if needed, avoiding oral trauma, and treating any secondary infection.

5. What is the prognosis for Angina Bullosa Haemorrhagica?

The prognosis is excellent, as the blisters typically heal on their own within a few days without scarring, although recurrence may occur in some individuals.