Angina bullosa haemorrhagica--a possible relation to steroid inhalers

Angina bullosa haemorrhagica (ABH) is a recently recognized condition, characterized by benign subepithelial blood-filled blisters in the mouth. The history is characteristic and distinction from other causes of oral blistering can be made by simple clinical signs or on histological grounds. This condition does not appear in standard dermatology texts, yet patients with ABH usually present to a dermatology clinic. A case with typical history is reported in an asthmatic patient who very regularly used a steroid inhaler. The possible aetiological role of such steroid-based inhalers is discussed.