Angina bullosa hemorrhagica: report of 4 cases.

Angina bullosa hemorrhagica is characterized by the sudden appearance of solitary or multiple hemorrhagic blisters on oral mucosa, with diameters ranging from 2 mm to 3 cm. The soft palate is most commonly affected, but angina bullosa hemorrhagica may also appear on the buccal mucosa, lips and tongue border. Clinically, the blisters have a dark red to purple appearance, and may or may not be painful. The blisters usually break, releasing bloody content and leaving an ulcer surface that heals within 7 to 10 days. In this article the authors describe four cases of angina bullosa hemorrhagica attended in Stomatology Department of Dental School, Sao Paulo State University. In case 1, a 29-year-old male presented with a sudden hemorrhagic blister on the soft palate. A drainage was performed and after seven days of follow-up the patient reported no symptoms. In case 2, a 63-year-old male presented complaining of a blister on the palate six days earlier that had spontaneously broken. General exam showed hypertension under medical control. An incisional biopsy was performed and after seven days follow-up the healing was completed. In case 3, a 61-year-old male arrived complaining of a sudden appearance of an hemorrhagic blister on the soft palate that had spontaneously broken. The patient had systemic hypertension under medical control. The ulcer healed in 10 days follow-up. In case 4, a 49-year-old woman presented complaining of pain and an ulcer on the soft palate. The patient reported the rapid onset of a blood blister during a meal that broke in few minutes. The resolution occurred after 14 days. Angina bullosa hemorrhagica seems to be more common than reported in the literature and knowledge of the condition is important to right diagnosis and approach when necessary.