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Author: Dr Mark Duffill, Hamilton, New Zealand, 2008
Angina (painful), bullosa (a blister), haemorrhagica (blood-filled, American spelling hemorrhagica) describes a condition where an, often painful, tense, blood-filled blister or blisters develop in the mouth.
The soft palate is the most common site. Other sites inside the mouth may be involved. There is usually a solitary lesion. Multiple blisters may develop. The blisters usually rupture spontaneously and the sites heal uneventfully
Possible causative factors include trauma, long-term use of topical or inhaled steroids, diabetes and hereditary predilection.
Other conditions which may need consideration include mucous membrane pemphigoid, bullous pemphigoid, lichen planus, epidermolysis bullosa, dermatitis herpetiformis, linear IgA disease and oral amyloidosis.
None are usually needed unless the above conditions need to be excluded. Skin antibodies may be measured. If a biopsy is taken in angina bullosa haemorrhagica, a blister will be found under the mucosa (lining of the mouth). This contains red blood cells and sparse inflammatory cells.
No treatment is usually necessary other than a mild analgesic and/or a simple mouth wash.
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