Hematidrosis: A Pathologic Process or Stigmata. A Case Report With Comprehensive Histopathologic and Immunoperoxidase Studies

Abstract

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.

Blood otorrhea: Blood stained sweaty ear discharges: Hematohidrosis; four case series (2001–2013)

“…The bleeding may occur from any area of unbroken skin anywhere in the body and may be unilateral, bilateral or symmetrical. It may be limited to a specific area or generalised 6,7 .…”

Bleeding from the eyes and through intact skin: Physiologic, structural, spiritual, or faked?

“…solving clinical problems in blood diseases including hands, feet, arms, and legs. Twinkle exhibited no apparent stress preceding or during her bleeding episodes, and it did not appear that her bleeding was emanating from hair follicles; however, based on prior case reports, neither of these factors is present in all cases [2,3]. Interestingly, hematidrosis is frequently determined to be a diagnosis in clinical scenarios where a serious diagnostic consideration is self inflicted bleeding.…”

“…Red blood cells may be observed within the follicular lumens on histopathology. The bloody sweat excretion can occur in situations of stress or exertion, and can be visualized on physical examination as emanating from the hair follicles [2]. A recent report by Wang et al found only minor extravasation of red blood cells and loosening of the connective tissue on histopathology in a 13-year-old female with hematidrosis [3], and a recent case in an 18-year-old female demonstrated no anatomic anomalies [4].…”

Haematidrosis: The Rare Phenomenon of Sweating Blood

“…Recently, however, scientific explanations have been proposed in multiple papers. The exact cause of this phenomenon is not completely understood, but activation of the sympathetic nervous system has been implicated [1]. In cases of extreme anxiety, the net--like form of multiple blood vessels that feed the sweat glands constricts and then dilates to the point of rupture.…”