Woman with sudden oral discomfort

Clinical introduction A 76-year-old woman presented to the ED from a French restaurant complaining of a sudden onset of oral discomfort that developed 1 hour after having a hot soup. Physical examination showed a 3x3 cm bullous haematoma on her soft palate (figure 1). She had repeated similar episodes of intraoral haematomas after meals, but other parts of the body had never been involved. Laboratory results were white blood cell count of 9000/mm3, haemoglobin 14.3 g/dL and platelet count 259 000/mm3. Coagulation tests of APTT and PT-INR were within the normal range. Question What is the most likely diagnosis? Angina bullosa haemorrhagica. Thrombocytopenia. Acquired haemophilia A. Oral malignant melanoma. Answer: A The patient was diagnosed with angina bullosa haemorrhagica (ABH). ABH presents as a haemorrhagic bulla with an ecchymotic halo in the oral cavity, especially on the soft...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: EMJ Image Challenge Source Type: research