Angina Bullosa Hemorrhagica (ABH) is an acute and benign condition which occurs due to the rapid onset of blood-filled blisters in the oral mucosa.
This condition is first explained in 1933 year as traumatic oral hemophlyctenosis and it was first used by Scientist called ‘Badham’ in 1967.
It may resemble with blood blisters which is caused by thrombocytopenia thus makes difficult to distinguish.
Epidemiology
Angina bullosa hemorrhagica affects to middle-aged or elderly individuals with 60% aged between 45 to 70 years old, and there is no document evidence for lesions in children below 10-year-old.
Anatomy
Pathophysiology
Subepithelial hemorrhage can be caused by a genetic predisposition to lose adhesion between the epithelium and corium of the mucosa of mucosal vessels.
Angina bullosa hemorrhagica (ABH) is a common soft tissue injury which affects the soft palate where the nonkeratinized, thin, and friable covers epithelium is present.
Etiology
Traumas arise from various sources which includes mechanical injuries like biting or dental procedures, and thermal injuries from hot foods or beverages.
Angina bullosa hemorrhagica is not caused by blood dyscrasia, vesiculobullous disorders, or systemic diseases thus a causative factor is not identified in 47% of patients.
Genetics
Prognostic Factors
Lesions of various sizes can resolve quickly with minimal discomfort and while larger lesion may stay longer thus causes more severe symptoms.
The general prognosis for ABH is more favourable.
Clinical History
ABH is the most observed condition in adults within age group of middle-aged to older individuals.
Physical Examination
Oral Examination
Blood-Filled Blisters assessment
Color and Appearance
Location of Lesions
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Patients may suddenly notice these lesions without any prior symptoms or warning signs.
ABH lesions can develop quickly as patients seen with blood-filled blisters or bullae shortly after symptom onset.
ABH lesions are painless and should be observed during routine oral examinations, eating, drinking, and oral hygiene activities.
Differential Diagnoses
Oral Vesiculobullous Disorders
Traumatic Oral Lesions
Oral Infections
Oral Malignancies
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Patients may suddenly notice these lesions without any prior symptoms or warning signs.
ABH lesions can develop quickly as patients seen with blood-filled blisters or bullae shortly after symptom onset.
ABH lesions are painless and should be observed during routine oral examinations, eating, drinking, and oral hygiene activities.
Education should be given to individuals about cautious with activities that could cause trauma to the oral mucosa.
Advise individuals to avoid strong mouthwashes, alcohol-based oral products, or tobacco smoke.
Schedule regular dental check-ups of patient to monitor their oral health and identify any new signs of mucosal trauma.
Provide enough education about ABH and its related causes, how it spreads, and how to stop with management strategies.
Use Topical Hemostatic Agents for treatment of Angina Bullosa Hemorrhagica
Thrombin: These hemostatic agents help to seal blood vessels and facilitate clot formation which reduces the risk of frequent bleeding. It is applied to the site of ruptured ABH lesions.
Use of Oral Analgesics for treatment of Angina Bullosa Hemorrhagica
Acetaminophen: They give systemic pain relief and may be used in conjunction with topical analgesics for optimal pain management.
Use of Topical Analgesics for treatment of Angina Bullosa Hemorrhagica
Benzocaine: It numb the affected area which reduces discomfort and makes it easier for patients to tolerate oral intake and it may be used as local pain reliever.
In cases where blood-filled blisters or bullae are large, tense, and causes significant discomfort with oral function, then incision and drainage may be considered.
In cases of recurrent lesions, Cauterization techniques such as laser ablation or electrocauterization may be performed to promote healing and avoid recurrence.
In the initial diagnosis phase, the physician assess symptoms related to ABH which is followed by diagnostic tests.
In the next phase, Symptomatic relief should be provided to reduce pain and improve the overall health of patients.
The regular follow-up visits with the dentist is required to check the improvement of patients and newly observed complaints along with treatment response.
Angina Bullosa Hemorrhagica (ABH) is an acute and benign condition which occurs due to the rapid onset of blood-filled blisters in the oral mucosa.
This condition is first explained in 1933 year as traumatic oral hemophlyctenosis and it was first used by Scientist called ‘Badham’ in 1967.
It may resemble with blood blisters which is caused by thrombocytopenia thus makes difficult to distinguish.
Angina bullosa hemorrhagica affects to middle-aged or elderly individuals with 60% aged between 45 to 70 years old, and there is no document evidence for lesions in children below 10-year-old.
Subepithelial hemorrhage can be caused by a genetic predisposition to lose adhesion between the epithelium and corium of the mucosa of mucosal vessels.
Angina bullosa hemorrhagica (ABH) is a common soft tissue injury which affects the soft palate where the nonkeratinized, thin, and friable covers epithelium is present.
Traumas arise from various sources which includes mechanical injuries like biting or dental procedures, and thermal injuries from hot foods or beverages.
Angina bullosa hemorrhagica is not caused by blood dyscrasia, vesiculobullous disorders, or systemic diseases thus a causative factor is not identified in 47% of patients.
Lesions of various sizes can resolve quickly with minimal discomfort and while larger lesion may stay longer thus causes more severe symptoms.
The general prognosis for ABH is more favourable.
ABH is the most observed condition in adults within age group of middle-aged to older individuals.
Oral Examination
Blood-Filled Blisters assessment
Color and Appearance
Location of Lesions
Patients may suddenly notice these lesions without any prior symptoms or warning signs.
ABH lesions can develop quickly as patients seen with blood-filled blisters or bullae shortly after symptom onset.
ABH lesions are painless and should be observed during routine oral examinations, eating, drinking, and oral hygiene activities.
Oral Vesiculobullous Disorders
Traumatic Oral Lesions
Oral Infections
Oral Malignancies
Patients may suddenly notice these lesions without any prior symptoms or warning signs.
ABH lesions can develop quickly as patients seen with blood-filled blisters or bullae shortly after symptom onset.
ABH lesions are painless and should be observed during routine oral examinations, eating, drinking, and oral hygiene activities.
Dermatology, General
Education should be given to individuals about cautious with activities that could cause trauma to the oral mucosa.
Advise individuals to avoid strong mouthwashes, alcohol-based oral products, or tobacco smoke.
Schedule regular dental check-ups of patient to monitor their oral health and identify any new signs of mucosal trauma.
Provide enough education about ABH and its related causes, how it spreads, and how to stop with management strategies.
Dermatology, General
Thrombin: These hemostatic agents help to seal blood vessels and facilitate clot formation which reduces the risk of frequent bleeding. It is applied to the site of ruptured ABH lesions.
Dermatology, General
Acetaminophen: They give systemic pain relief and may be used in conjunction with topical analgesics for optimal pain management.
Dermatology, General
Benzocaine: It numb the affected area which reduces discomfort and makes it easier for patients to tolerate oral intake and it may be used as local pain reliever.
Dermatology, General
In cases where blood-filled blisters or bullae are large, tense, and causes significant discomfort with oral function, then incision and drainage may be considered.
In cases of recurrent lesions, Cauterization techniques such as laser ablation or electrocauterization may be performed to promote healing and avoid recurrence.
Dermatology, General
In the initial diagnosis phase, the physician assess symptoms related to ABH which is followed by diagnostic tests.
In the next phase, Symptomatic relief should be provided to reduce pain and improve the overall health of patients.
The regular follow-up visits with the dentist is required to check the improvement of patients and newly observed complaints along with treatment response.
Angina Bullosa Hemorrhagica (ABH) is an acute and benign condition which occurs due to the rapid onset of blood-filled blisters in the oral mucosa.
This condition is first explained in 1933 year as traumatic oral hemophlyctenosis and it was first used by Scientist called ‘Badham’ in 1967.
It may resemble with blood blisters which is caused by thrombocytopenia thus makes difficult to distinguish.
Angina bullosa hemorrhagica affects to middle-aged or elderly individuals with 60% aged between 45 to 70 years old, and there is no document evidence for lesions in children below 10-year-old.
Subepithelial hemorrhage can be caused by a genetic predisposition to lose adhesion between the epithelium and corium of the mucosa of mucosal vessels.
Angina bullosa hemorrhagica (ABH) is a common soft tissue injury which affects the soft palate where the nonkeratinized, thin, and friable covers epithelium is present.
Traumas arise from various sources which includes mechanical injuries like biting or dental procedures, and thermal injuries from hot foods or beverages.
Angina bullosa hemorrhagica is not caused by blood dyscrasia, vesiculobullous disorders, or systemic diseases thus a causative factor is not identified in 47% of patients.
Lesions of various sizes can resolve quickly with minimal discomfort and while larger lesion may stay longer thus causes more severe symptoms.
The general prognosis for ABH is more favourable.
ABH is the most observed condition in adults within age group of middle-aged to older individuals.
Oral Examination
Blood-Filled Blisters assessment
Color and Appearance
Location of Lesions
Patients may suddenly notice these lesions without any prior symptoms or warning signs.
ABH lesions can develop quickly as patients seen with blood-filled blisters or bullae shortly after symptom onset.
ABH lesions are painless and should be observed during routine oral examinations, eating, drinking, and oral hygiene activities.
Oral Vesiculobullous Disorders
Traumatic Oral Lesions
Oral Infections
Oral Malignancies
Patients may suddenly notice these lesions without any prior symptoms or warning signs.
ABH lesions can develop quickly as patients seen with blood-filled blisters or bullae shortly after symptom onset.
ABH lesions are painless and should be observed during routine oral examinations, eating, drinking, and oral hygiene activities.
Dermatology, General
Education should be given to individuals about cautious with activities that could cause trauma to the oral mucosa.
Advise individuals to avoid strong mouthwashes, alcohol-based oral products, or tobacco smoke.
Schedule regular dental check-ups of patient to monitor their oral health and identify any new signs of mucosal trauma.
Provide enough education about ABH and its related causes, how it spreads, and how to stop with management strategies.
Dermatology, General
Thrombin: These hemostatic agents help to seal blood vessels and facilitate clot formation which reduces the risk of frequent bleeding. It is applied to the site of ruptured ABH lesions.
Dermatology, General
Acetaminophen: They give systemic pain relief and may be used in conjunction with topical analgesics for optimal pain management.
Dermatology, General
Benzocaine: It numb the affected area which reduces discomfort and makes it easier for patients to tolerate oral intake and it may be used as local pain reliever.
Dermatology, General
In cases where blood-filled blisters or bullae are large, tense, and causes significant discomfort with oral function, then incision and drainage may be considered.
In cases of recurrent lesions, Cauterization techniques such as laser ablation or electrocauterization may be performed to promote healing and avoid recurrence.
Dermatology, General
In the initial diagnosis phase, the physician assess symptoms related to ABH which is followed by diagnostic tests.
In the next phase, Symptomatic relief should be provided to reduce pain and improve the overall health of patients.
The regular follow-up visits with the dentist is required to check the improvement of patients and newly observed complaints along with treatment response.
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