Angina bullosa hemorrhagica

Background In 1967, Badham used the term angina bullosa hemorrhagica (ABH) to describe an entity we already knew as traumatic oral hemophlyctenosis (T OH) (1933) and later renamed recurrent oral hemophlyctenosis (ROH) (1971). Objectives The objective of this study was to review and discuss the litera ture, and to report 54 new cases seen between 1989 and 1996. Materials and methods Fifty-four patients were thoroughly assessed to deter mine the clinical features, histology, etiology, pathogenesis, differential diagnosis, and therapy. Results In 35 patients (64.8%), the lesions predom inated on the palate and in nine (16.6%) on the oral mucosa. The incidence was similar in both sexes (women, 52%; men, 48%) and the condition affected mostly the 51-70-year age group. ABH was never documented in children unde r 10 years of age. In 24 cases (44.4%), diabetes mellitus, hyperglycemia, a nd/or a family history of diabetes was found. Conclusions ABH is a disorder more common than the literature would suggest . Although the causes may be multiple (mucosal trauma, inhaled corticostero ids), the available data indicate that, in these patients, the presence of an alteration in glucose metabolism should be considered.