Yorulmaz Ahu, Yalcin Basak
Department of Dermatology, Ankara Numune Research and Education Hospital, Ankara, Turkey.
Indian J Pharmacol. 2018 Mar-Apr;50(2):91-93. doi: 10.4103/ijp.IJP_19_17.
Angina bullosa hemorrhagica (ABH) is an infrequent dermatosis characterized by acute onset of hemorrhagic bulla in the oral cavity. Clinical presentation of ABH may be quite worrisome, and clinicians often feel skeptical regarding their clinical diagnosis and lack confidence in managing this distinct entity. Indeed, ABH is a completely benign and self-limited disorder. The exact etiopathogenesis of ABH is still unknown. There have been reports in the literature addressing a central role for mechanical instability of the epithelial-connective tissue connection in the pathogenesis of ABH. Moreover, it has been claimed that long-term usage of inhaled glucocorticoids (GCs) is involved in the development of ABH, since most of the reported cases are asthmatic patients, who were treated with inhaled GCs, and GCs are well known for their degradative activities on collagen formation. Here, we describe a case with ABH, who had a drug history of inhaled GCs and nonsteroidal anti-inflammatory drugs (NSAIDs). We assume that our case not only supports the association of inhaled GCs with ABH but also suggests a possible role for NSAIDs in the pathogenesis of ABH.
出血性大疱性心绞痛（ABH）是一种罕见的皮肤病，其特征为口腔内急性出现出血性大疱。ABH的临床表现可能相当令人担忧，临床医生常常对其临床诊断持怀疑态度，且对管理这一独特病症缺乏信心。事实上，ABH是一种完全良性且自限性的疾病。ABH的确切病因仍不清楚。文献中有报道称上皮-结缔组织连接的机械不稳定性在ABH的发病机制中起核心作用。此外，有人声称长期使用吸入性糖皮质激素（GCs）与ABH的发生有关，因为大多数报道的病例都是接受吸入性GCs治疗的哮喘患者，而且GCs以其对胶原蛋白形成的降解活性而闻名。在此，我们描述一例患有ABH的病例，该患者有吸入性GCs和非甾体抗炎药（NSAIDs）的用药史。我们认为我们的病例不仅支持吸入性GCs与ABH的关联，还提示了NSAIDs在ABH发病机制中可能发挥的作用。
