Hemorrhagic lip and oral mucosal blisters

A 79-year-old Chinese woman presented with progressive hemorrhagic lip and oral mucosal blisters with purplish spots on her chin and cheeks. There was no antecedent trauma, contactants, or use of dentures. She was not undergoing antiplatelet or anticoagulant therapy. The physical examination revealed hemorrhagic bullae and erosions on the lower lip and purpuric macules on the chin, nasolabial folds, and lips (Fig 1). Laboratory results revealed an elevated creatinine level of 377 mmol/L. Her platelet count and coagulation profiles were normal.

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