Description

50 year old male presented with complaints of sudden onset rapidly progressive swelling from the oral cavity causing airway obstruction but ruptured spontaneously causing an ulcer in the palate following intake of hot liquid. Patient gave history of previous similar swelling which spontaneously ruptured. Examination revealed a single diffuse ulcerated lesion with hemorrhagic spots and surrounding erythema of size 3 x 2 cm involving midline of soft palate extending onto hard palate and inferiorly upto uvula (Figure 1).

Based on history and clinical examination, a diagnosis of Angina Bullosa Hemorrhagica was made. Patient was advised analgesics along with avoidance of inciting factors such as intake of hot foods and reassured. Patient improved symptomatically and the lesion completely resolved on follow up after two weeks.

Angina Bullosa Hemorrhagica is a rare idiopathic benign condition that occurs in oral cavity and oropharynx. It is characterized by the sudden appearance of a painless blood filled bullous lesion on gums, tongue or palate. It occurs secondary to trauma to the affected area such as ingestion of hot and spicy foods. Most lesions resolve spontaneously although some may cause life threatening airway obstruction requiring surgical drainage [1-3].

Figure 1: Single diffuse ulcerated lesion of size 3 x 2 cm with hemorrhagic spots, irregular margins, ragged mucosal edges and surrounding erythema involving midline of soft palate extending onto hard palate and inferiorly upto uvula.

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References

1. Rai S, Kaur M, Goel S. Angina bullosa hemorrhagica: report of two cases. Indian J Dermatol. 2012; 57: 503.
2. En El Paladar Blando LA. Atypical lesion on soft palate: A curious case. Int. J. Odontostomat. 2010; 4: 9-12.
3. Horie N, Kawano R, Inaba J, Numa T, Kato T, Nasu D, Kaneko T, Kudo I, Shimoyama T. Angina bullosa hemorrhagica of the soft palate: a clinical study of 16 cases. Journal of oral science. 2008; 50: 33-6.