Autoerythrocyte sensitization syndrome presenting with general neurodermatitis

Oh, Il Young; Ko, Eun Jung; Li, Kapsok

doi:10.5415/apallergy.2013.3.3.204

“…Previously, AES has been described as psychogenic purpura owing to its presence in stress-prone females. [ 10 ] Our findings further reaffirm that psychological stress is an important factor in the pathogenesis of AES. Not all the AEST showed positive results, suggesting that positive ecchymoses are due to RBC antigenicity and not a normal occurrence in response to WRBC injection [ Table 1 ].…”

Section: Discussionsupporting

confidence: 78%

Role of autoerythrocyte sensitization test in the diagnosis of recurrent spontaneous bruising

Singh¹,

Prabhash²,

Prabha³

et al. 2023

Indian Dermatol Online J

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Introduction: Psychogenic purpura, also known as autoerythrocyte sensitization syndrome, is a rare condition which is characterized by spontaneous development of painful purpura, or ecchymoses. Skin lesions are usually preceded by stress and emotional trauma. It is usually a diagnosis of exclusion after ruling out history of trauma, drug intake and other bleeding disorders. Autoerythrocyte sensitization test (AEST) and a psychiatric evaluation helps in the diagnosis and treatment. Objective: To demonstrate the importance of AEST in diagnosing the patient of Gardner Diamond syndrome. Materials and Methods: Five suspected cases of autoerythrocyte sensitization syndrome underwent AEST after ruling out other causes of bleeding. Results: Four out of five patients were positive for AEST while one patient was negative. Psychiatric complaints were present in three patients. One patient was lost to follow up. Rest all patients responded well to vitamin C supplementation. Conclusion: Autoerythrocyte sensitization syndrome is a rare disorder and is a diagnosis of exclusion, so a thorough workup of the patient to rule out common causes of bruising is essential. A high index of suspicion on the clinician’s part and a simple OPD-based AEST may help in the diagnosis. Psychiatric consultation is important to find out the stress factor and timely management.

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“…Treatment of psychogenic purpura involves symptomatic management with glucocorticosteriods, antihistamines, and antibiotics but yields variable results [33,34]. Antidepressant medications and psychotherapy factor, often outweighed by other patient factors.…”

Section: Psychogenic Purpuramentioning

confidence: 99%

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2019

J Otolaryngol Rhinol

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exploring epistaxis with a psychiatric aetiology. This paper aims to summarise the existing literature documenting the various causes and management of psychiatric epistaxis-an uncommon cause for a common condition. TraumaPsychiatric conditions presenting as traumatically induced epistaxis appear in two distinct groups; chronic trauma due to compulsive behaviours, and acute injuries.Epistaxis secondary to trauma, especially digital trauma, is well established as a common presenting complaint [5]. Compulsive nose picking, termed rhinotillexomania, is a common habit with reported rates of up to 97.5% [6] in adolescents and 91% of adults [7]. Rates of epistaxis secondary to rhinotillexomania in these studies were 25% for adolescents [7] and 18% for adults [6]. Jefferson, et al. also reported a coexistence of nail biting, cuticle picking, hair pulling, and scratching of a specific spot in individuals with frequent rhinotillexomania.Chronic rhinotillexomania is associated with self-mutilation, typically resulting in erosion and/ or perforation of the nasal spectrum, turbinates, ethmoidal sinus, medial orbital wall [8][9][10][11]. The self-reported rate of injuries more serious than a simple bleed ranges from 0.8% to 2% of those with rhinotillexomania [6,7].Self-mutilation is defined as a deliberate act of destruction and/or body alteration without suicidal intent and is noted to occur in a wide variety of psychiatric conditions [12,13]. Major self-mutilation that results in permanent organ loss or dysfunction is

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“…In this case, the speculative mechanism of injury was attempted suicide via selfinsertion of objects into his nose and then ramming them against a hard surface [17]. To date, the number are recommended, particularly in cases with clear psychiatric pathology [34].…”

Section: Foreign Bodiesmentioning

confidence: 99%

The Psychiatric Aetiologies of Epistaxis

William¹

2019

J Otolaryngol Rhinol

0

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exploring epistaxis with a psychiatric aetiology. This paper aims to summarise the existing literature documenting the various causes and management of psychiatric epistaxis-an uncommon cause for a common condition. TraumaPsychiatric conditions presenting as traumatically induced epistaxis appear in two distinct groups; chronic trauma due to compulsive behaviours, and acute injuries.Epistaxis secondary to trauma, especially digital trauma, is well established as a common presenting complaint [5]. Compulsive nose picking, termed rhinotillexomania, is a common habit with reported rates of up to 97.5% [6] in adolescents and 91% of adults [7]. Rates of epistaxis secondary to rhinotillexomania in these studies were 25% for adolescents [7] and 18% for adults [6]. Jefferson, et al. also reported a coexistence of nail biting, cuticle picking, hair pulling, and scratching of a specific spot in individuals with frequent rhinotillexomania.Chronic rhinotillexomania is associated with self-mutilation, typically resulting in erosion and/ or perforation of the nasal spectrum, turbinates, ethmoidal sinus, medial orbital wall [8][9][10][11]. The self-reported rate of injuries more serious than a simple bleed ranges from 0.8% to 2% of those with rhinotillexomania [6,7].Self-mutilation is defined as a deliberate act of destruction and/or body alteration without suicidal intent and is noted to occur in a wide variety of psychiatric conditions [12,13]. Major self-mutilation that results in permanent organ loss or dysfunction is

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Autoerythrocyte sensitization syndrome presenting with general neurodermatitis

Cited by 6 publications

References 7 publications

Role of autoerythrocyte sensitization test in the diagnosis of recurrent spontaneous bruising

Role of autoerythrocyte sensitization test in the diagnosis of recurrent spontaneous bruising

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The Psychiatric Aetiologies of Epistaxis

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