Cases of hematidrosis (bloody sweat) are extremely rare. This disease has been described in various terms and has been often tied to religious belief as stigmatization. We report a typical patient with hematidrosis in a 14-year-old girl who frequently bled from her scalp and palms, and, occasionally, from trunk, soles, and legs. The bloody sweat from her scalp contained all blood elements. Immediate biopsy after there was bleeding on her scalp showed multiple blood-filled spaces that opened directly into the follicular canals or on to the skin surface. Immunoperoxidase studies failed to demonstrate vascular nature of these spaces. Our study explained how and why there was bleeding in our patient and in patients with related conditions as described in earlier literatures. We also explained why this phenomenon was intermittent because the spaces indicated above will disappear after exuding their content but then reoccurred after the blood flow was reestablished.
Nevus sebaceous of Jadassohn (SNJ) is a congenital, hamartoma of multiple skin structures and may classically evolve through several stages of maturation. Many neoplasms have been reported to arise in association with SNJ, most commonly trichoblastoma and syringocystadenoma papilliferum. The coexistence of 3 or more tumors arising simultaneously within 1 lesion of SNJ is very rare. We report a case of a 66-year-old woman with a coexistence of trichoblastoma, trichilemmoma, sebaceous adenoma, tumor of follicular infundibulum, syringocystadenoma papilliferum, and mucoepidermoid or adenosquamous carcinoma arising in 2 separate and persistent SNJ exhibiting on her face with subsequent parotid node metastasis. This report illustrates an extraordinary case of adnexal neoplasms displaying diverse lines of differentiation arising within lesions of SNJ. We also reported the second instance of mucoepidermoid arising within the lesion of SNJ and also added sebaceous adenoma to the list of sebaceous tumors arising within this lesion. Prophylactic excision or at least close clinical surveillance for sudden development of new growths is warranted.
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