Salt-associated angina bullosa haemorrhagica in a child: A case report with literature review.

Angina bullosa haemorrhagica is a rare, benign, self-limiting oral mucosal disorder characterised by the sudden appearance of blood-filled bullae in the absence of systemic or haematological abnormalities. Paediatric cases remain exceptionally uncommon. This report describes a 5-year-old Saudi Arabian boy who presented with multiple painless haemorrhagic oral bullae after ingesting natural salt crystals during a visit to a salt lake in Al-Qassim, Saudi Arabia. Clinical examination revealed 18 haemorrhagic bullae involving the buccal mucosa, labial mucosa, and tongue, without systemic symptoms or signs of trauma. Laboratory investigations were unremarkable, and a probable clinical diagnosis of angina bullosa haemorrhagica temporally associated with salt ingestion was established. The lesions ruptured spontaneously within 24 h and healed completely without scarring within 7 days. A literature review identified 40 reported cases from 26 studies, with idiopathic causes and local traumatic or dietary factors being the most commonly associated findings. This report highlights the importance of recognising angina bullosa haemorrhagica in children and considering possible environmental or dietary contributing factors while avoiding unnecessary investigations and interventions.