Hemorrhagic bullae of the oral mucosa

ABH: angina bullosa hemorrhagica H&E: hematoxylin-eosin INTRODUCTION Angina bullosa hemorrhagica (ABH) is a rare benign disorder characterized by sudden onset of painless, blood-filled, blisters of the oral cavity that quickly expand and rupture spontaneously within 24 to 48 hours. First reported in 1967, ABH has been noted under other diagnostic terms including recurrent or traumatic oral hemophlyctenosis and benign hemorrhagic bullous stomatitis. Localization of blisters is usually restricted to the soft palate, yet the buccal mucosa, tongue, and lips may also be involved. Associated symptoms have been noted in some cases, including hoarseness and blood-tinged sialorrhea. Blisters tend to heal without scarring. Most cases occur in adults, ages 50 to 70, with no differentiation in incidence between men or women. Because it is infrequently encountered in the clinical setting and sparsely reported in the dermatologic literature, its recognition and diagnosis make it challenging for providers. We report a recent case of ABH in a middle-aged man with idiopathic thrombocytopenia, including its emergent presentation and relevant histopathology.