Angina Bullosa Hemorrhagica Workup

Updated: Sep 12, 2022
  • Author: Kara Melissa Torres Culala, MD; Chief Editor: Dirk M Elston, MD  more...
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Histologic Findings

The diagnosis of angina bullosa hemorrhagica (ABH) essentially is clinical; however, in cases in which biopsies have been performed, microscopic examination were non-specific and revealed a subepithelial bulla containing RBCs and an underlying mild and nonspecific chronic lymphocytic inflammatory cell infiltrate that generally is limited to the region of the lamina propria. The surface epithelium may be intact or show nonspecific ulceration. Fibrinoid material within the blister and/or beneath the basement membrane may also be present. [22] In 1 report, angina bullosa hemorrhagica was reported to mimic a neutrophil-rich subepithelial blistering disorder. [5]

Direct immunostaining for immunoglobulin G, immunoglobulin A, immunoglobulin M, and fibrin is usually negative; however, there may be equivocal staining for immunoglobulin G and C3 along the basement membrane zone. [7, 31]