Expanding the histologic spectrum of angina bullosa hemorrhagica: report of one case.

Angina bullosa hemorrhagica (ABH) is a rarely described phenomenon in the dermatology/dermatopathology literature. It is a self-limited condition occurring exclusively in the oral mucosa characterized clinically by tense hemorrhagic blisters that heal without any sequelae and histologically by a pauci-inflammatory subepithelial hemorrhagic bulla with occasional lymphocytic infiltrate.A 24-year-old healthy woman presented with a 4-month history of recurrent tense blisters over the buccal mucosa which lasted for a few days and resolved without scarring. Histopathology revealed a hemorrhagic subepithelial bulla containing numerous neutrophils with a moderately dense superficial perivascular and interstitial neutrophilic infiltrate. Direct immunofluorescence studies were negative. Based on these findings, the diagnosis of ABH was made. To the best of our knowledge, this is the first report of ABH mimicking histologically neutrophil-rich subepithelial blistering disorders.