Angina Bullosa Haemorrhagica Research Articles

Photobiomodulation for Angina Bullosa Haemorrhagica treatment: a case report

Angina Bullosa Haemorrhagica is an alteration causing recurrent hemorrhagic blisters, which rupture easily and are located exclusively in the oropharyngeal or oral mucosa in sites particularly exposed to trauma. These lesions rupture spontaneously to form ragged, often painless, superficial erosions that heal spontaneously within 1-2 weeks without scarring. This case report describes the use of Photobiomodulation by 635nm laser, suggesting its utilization for pain reduction as well as for a faster healing process.

Pharyngeal Haemorrhage Immediately After Intake of Fried Foods: Angina Bullosa Haemorrhagica.

The key to the diagnosis of angina bullosa haemorrhagica (ABH) is a history of acute haemorrhagic vesicles caused by an external stimulus such as food or intubation, which resolve without scarring within a week or so.ABH can occur at any oropharyngeal site, but its occurrence in the pharyngeal region raises the risk of airway obstruction due to haematemesis.

Angina Bullosa Haemorrhagica in COVID 19: A Diagnostic Conundrum. Case Report and Review of Literature

Oral manifestations of COVID-19 are amongst the most obscure and ill-reported. Of these, angina bullosa haemorrhagica is amongst the rarest. Only 2 cases of angina bullosa haemorrhagica in COVID-19 patients have been reported in literature. Angina bullosa haemorrhagica (ABH) is an enigmatic, abstruse condition represented by sudden onset of painful subepithelial, mucosal blood-filled vesicles and bullae in the oral cavity. It is not attributed to any systemic conditions, blood dyscracias or other well-known dermatological pathologies. The occurrence of these lesions in patients of COVID-19 suggests that the underlying pathology of the latter may predispose to ABH and thus help in shedding some light onto the pathogenesis of this obscure disease. Herein we present 2 cases of ABH in patients of COVID-19 within a few weeks of the resolution of the latter. Both patients reported that they had never had this condition before and that this was the first presentation of the symptom. A review of literature shows that the etiopathogenesis of ABH is ambiguous at best and that the pathology underlying the oral manifestation of COVID-19 may well be applicable to ABH as well. Various mechanisms have been proposed to cause oral manifestations in COVID-19 patients. These include imbalance in the RAS pathway causing mucosal disruption, immune dysregulation, deranged cellular immune mechanism and disruption of local immune mechanisms. Since ABH has been reported in COVID 19, it is plausible that some of the mechanisms underlying the pathogenesis of oral manifestations may explain the pathogenesis of ABH.

Angina Bullosa Hemorrhagica: Frightening Experience-A Case Series.

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 48years. 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 1day duration. Five of the patients had solitary lesions, while one had multiple lesions. The lesions measured from 1 to 3cm 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.

Multiple angina bullosa haemorrhagica like oropharyngeal lesions associated with severe acute respiratory syndrome coronavirus 2-induced immune thrombocytopenia: A rare case report

Rationale: Angina bullosa hemorrhagica (ABH) or blood blisters have an acute onset and occur independently of other disturbances of the human body like vesiculo-bullous disorders, vascular disorders, systemic causes etc. ABH is sometimes painful in the oral cavity, most commonly affects the soft palate and less commonly affects the masticatory mucosa. Within a short period of time, these blood filled lesions burst spontaneously resulting in superficial erosions and healing without scarring within 1-2 weeks. ABH has a good prognosis and the only complication reported in the literature has been of airway obstruction. Patient Concerns: A 50 yr old female patient presented with the chief complaint of blood filled blisters and bleeding gums since one week. Diagnosis: Blood filled blisters were noted at multiple sites in the oral mucosa. Blood investigation revealed mild alteration in platelet count and endoscopy displayed involvement of the pharyngeal mucosa. A provisional diagnosis of ABH-like lesion as a covid -19 related delayed inflammatory reaction to LA was given. Interventions: Symptomatic management with topical agents was done. Outcomes: The lesions had completely healed by the seventh day and she remains symptom free eight months post episode. Lessons: The presented case is a very rare condition affecting the oral cavity and involvement of the pharyngeal mucosa additionally in a post COVID-19 patient is even more rare. A delayed inflammatory reaction to LA due to exposure to the SARS-COV-2 spike protein and dysregulation in immune function associated with immune thrombocytopenia (ITP) are postulated in this case of ABH-like lesions involving the oro-pharyngeal mucosa. It is very important to be clinically observant in recovered covid 19 patients too for atypical presentations.

Angina bullosa haemorrhagica: A 14-year multi-institutional retrospective study from Brazil and literature review.

Background Angina bullosa haemorrhagica (ABH) is characterized by the recurrent appearance of blood blisters on the oral mucosa, mainly in adults' soft palate. In general, the blisters rupture spontaneously, lacking the necessity for biopsy. We report the clinical features of 23 ABH cases, emphasizing the clinical behavior and the management of these conditions.Material and Methods A retrospective descriptive cross-sectional study was performed. A total of 12,727 clinical records of oral and maxillofacial lesions from four dental services in Brazil were analyzed. Clinical data were collected from the clinical records and evaluated.Results The series comprised 12 males (52.2%) and 11 females (47.8%), with a mean age of 56.8 ± 14.6 years (ranging: 24-82 years) and a 1.1:1 male-to-female ratio. Most of the lesions affected the soft palate (n = 15, 65.2%). Clinically, the lesions presented mainly as an asymptomatic (n = 17, 73.9%) blood-filled blister that ruptured after a few minutes or hours, leaving an erosion. The masticatory trauma was the most frequent triggering event. No patient had coagulation disorders. A biopsy was performed in only four cases (17.4%). Treatment was symptomatic with a favorable outcome.Conclusions ABH is still poorly documented in the literature, and its etiology remains uncertain. ABH mainly affects the soft palate of elderly adults and has a favorable evolution in a few days. The therapeutic approach is often focused only on the relief of symptoms. However, it can share some clinical features with more serious diseases. Therefore, clinicians must recognize these lesions to avoid misdiagnosis. Key words:Angina bullosa haemorrhagica, diagnosis, oral mucosa blisters.

Expression of Histo-blood Group Antigens in Tumor and Adjacent Normal Breast Tissues as Prognostic Markers of Breast Carcinoma.

PurposeAberrant glycosylation of the histo-blood group antigens (including the angina bullosa haemorrhagica [ABH]) is often observed during malignant transformation in most types of carcinomas. Data concerning their ethnic distributions are diverse which explains why their biological characteristics have to be studied in different populations. Our aim was to analyze the expression of the histo-blood group (specifically the ABH) antigens in breast carcinoma.MethodsThe expression of the histo-blood group (specifically the ABH) antigens was studied in 109 patients with breast carcinoma using immunohistochemistry. Statistical analysis was performed using χ2 and Fisher analyses.ResultsThe loss of expression of histo-blood group (ABH) antigens in breast carcinoma was observed in 81.13% of patients with blood group O, 37.93% with blood group A, and 96.30% with blood group B. One key finding of this study was that the loss of expression of the ABH antigen was also observed in normal tissues adjacent to the tumor. The loss of expression was associated with higher tumor grade (p < 0.05). Expression of H antigen was observed in 50% of cases with loss of expression of B antigen and was associated with human epidermal growth factor receptor 2 (HER2) overexpression (p < 0.05). The loss of H antigen in patients with blood group O was associated with estrogen receptor expression (p < 0.001). Incompatible A antigen in tumor was expressed in 20.75% of patients with blood group O.ConclusionLoss of the ABH antigens correlated with the Scarff-Bloom-Richardson histologic grading. H antigen was associated with HER2 overexpression in breast cancer. However, further studies are needed to determine the role of incompatible A antigen in mammary carcinogenesis.

Angina bullosa haemorrhagica-like lesions in pemphigus vulgaris.

The aim of this study was to describe a previously unreported association of oral pemphigus vulgaris with short-lived blood-filled painless blisters resembling angina bullosa haemorrhagica (ABH). A cross-sectional study of consecutive patients with Pemphigus vulgaris. All patients were examined for the presence of ABH-like lesions, and demographic, clinical and histopathological data were collected. Histopathological examination was performed when feasible. A total of 318 with pemphigus vulgaris were included (63.5% female, mean age: 46years). ABH-like lesions were present in 82 (25.8%) patients, commonly observed in the buccal mucosa (47, 57.3%) followed by the palate (15, 18.3%). All patients had normal platelet counts with no evidence of bleeding diathesis. Biopsies of the ABH-like lesions showed suprabasal clefts in four of six samples. ABH-like lesions were significantly associated with partial remission of pemphigus vulgaris (47.5%, P=0.002) and the use of intraoral steroids (P=0.001, odds ratio: 5.9 [95% confidence interval: 2.5-13.6]). ABH-like lesions may represent a transient or abortive form of oral pemphigus vulgaris and tend to have a benign and self-limiting nature.

気管挿管中に発見されたAngina Bullosa Haemorrhagicaの1例

Angina bullosa haemorrhagica（以下ABH）は血液異常や水疱性疾患のような全身疾患とは無関係に，突然口腔内に血疱を生じる疾患である．典型例では血疱出現の後，自壊し治癒するため臨床上問題となることは少ない．しかし血疱により気道閉塞した症例も報告されており，麻酔管理においては慎重を要する．今回術中にABHが発見され，慎重な抜管およびICUでの経過観察により問題なく全身管理できた症例を経験した．

Angina bullosa haemorrhagica—a review of 14 cases

This article describes 14 cases of angina bullosa haemorrhagica. Angina bullosa haemorrhagica is a pathology restricted to the oral mucosa, commonly observed on the soft palate. It is characterized by a bloody bubble without systemic blood diseases associated or any other known illness related. The expression angina is used because the lesion can produce a chock sensation in the patient. The prognosis is good and the treatment is only symptomatic, avoiding secondary infection and improving the wound healing.

Angina bullosa haemorrhagica: a disorder to keep in mind

Auteur(s) : David Serra, Hugo Schonenberger De Oliveira, Jose Pedro Reis, Ricardo Vieira, Americo Figueiredo University Hospital of Coimbra, Dermatology Department, Praceta Prof Mota Pinto, 3000-075 Coimbra, Portugal Angina bullosa haemorrhagica (ABH) is a blistering disorder of the oropharyngeal mucosa that has not received much attention from the dermatological community. We studied 4 patients (2 male and 2 female; mean age: 59.5 years; range: 44-66 years) [...]

Recognising the side-effects of steroid use

A pictorial presentation to download showing the side-effects of steroid use including skin atrophy, tinea incognito, acne rosacea, telangiectasia and purpura, angina bullosa haemorrhagica and osteoporosis.

Angina bullosa haemorrhagica-a possible relation to steroid inhalers

Angina bullosa haemorrhagica (ABH) is a recently recognized condition, characterized by benign subepithelial blood-filled blisters in the mouth. The history is characteristic and distinction from other causes of oral blistering can be made by simple clinical signs or on histological grounds. This condition does not appear in standard dermatology texts, yet patients with ABH usually present to a dermatology clinic. A case with typical history is reported in an asthmatic patient who very regularly used a steroid inhaler. The possible aetiological role of such steroid-based inhalers is discussed.

Ａｎｇｉｎａ Ｂｕｌｌｏｓａ Ｈａｅｍｏｒｒｈａｇｉｃａ（ＡＢＨ）の４例

The term Angina Bullosa Haemorrhagica (ABH) was first used by Badham (1967) to describe blood blisters on the oral mucosa which appeared to be unrelated to defined disorders such as bullous diseases or blood dyscrasias. He suggested that ABH occurred most often on the soft palate after eating toast or some other hard food or drinking hot drinks.Typically blood blisters occur singly and enlarge suddenly to two or three centimetres in diameter. They burst shortly afterwards and are found to have ragged erosions. After two or three days, epithelialisation begins from the margins or from numerous small islands within the larger erosions which healed without scarring.This paper presents case reports of four patients with ABH.

Angina bullosa haemorrhagica-a report of three cases and review of the literature

Angina bullosa haemorrhagica (ABH) is a term that was first introduced by Badham in 1967 to describe a bullous disorder in which recurrent oral blood blisters appear in the absence of any identifiable systemic disorder. The aetiology of this condition remains obscure. Three cases are described, and their similarities and differences discussed. In one case the histopathology showed an intradermal blister; this feature has not previously been recorded for this condition.

Oral blood blisters in angina bullosa haemorrhagica secondary to trauma of eating and dental injection'

Oral blood blisters in angina bullosa haemorrhagica secondary to trauma of eating and dental injection'

Angina bullosa haemorrhagica: Lesional immunostaining and haematological findings

The aetiology of angina bullosa haemorrhagica remains obscure. Fourteen patients with clinical features suggestive of angina bullosa haemorrhagica were investigated. Haemostatic function tests were carried out on an initial 5 patients and immunostain studies on a total of 12 patients. The results indicate that the aetiology of angina bullosa haemorrhagica is associated with neither a haemostatic defect, nor an immunopathogenic basis, and the cause is, as yet, unclear.

Angina bullosa haemorrhagica: Clinical and laboratory features in 30 patients

Angina bullosa haemorrhagica (ABH) is a relatively recently recognized bullous disorder in which recurrent oral blood blisters appear in the absence of any identified systemic disorder. This study has examined the clinical, histologic, immunologic, and hemostatic features of 30 British patients and demonstrates that ABH is predominantly a localized disorder of middle-aged or elderly patients of either sex that is evident mainly as blood blisters on the soft palate. Trauma appears to be the most common identifiable precipitating factor, but the essential tissue defect is as yet unidentified.