Pediatric hematidrosis – A case report and review of the literature and pathogenesis

Abstract

Hematidrosis is a disorder in which blood-tinged fluid exudes from uninjured skin or mucosa. It is often classified as an eccrine sweat disorder, though the precise mechanism-including involvement of sweat glands-has yet to be proven. In contemporary case reports, hematidrosis appears most frequently in the pediatric population, with 83% of cases in the literature since 2008 occurring in individuals 18 years old or younger. We present here a case of a 10-year-old girl with hematidrosis followed by a review of the literature, with an emphasis on the features of this condition in the pediatric population.

A Strange Occurrence of Hematohidrosis: A Case Report From Saudi Arabia

“…The second is that most patients improve or go into remission after taking beta-blockers and/or antidepressants, antianxiolytics, or psychotherapy [ 2 ]. According to a literature review done in 2021, treatment with beta-blockers had an effectiveness of up to 94%, while psychotherapy (including cognitive-behavioral therapy, relaxation techniques, and family education) had an effectiveness of 66% [ 5 ]. Idiosyncratically, our patient was a 20-year-old female, unlike the usual age presentation of the disease.…”

“…Idiosyncratically, our patient was a 20-year-old female, unlike the usual age presentation of the disease. It has been reported that 83% of hematohidrosis patients present at age 18 and younger [ 5 ]. Although our case involved a Saudi female, hematohidrosis has been rarely reported in the region.…”

“…Although our case involved a Saudi female, hematohidrosis has been rarely reported in the region. Out of 36 multinational cases of hematohidrosis, the highest number of cases were in India with a total of 13 patients, followed by South Africa with four, and Iran with three [ 5 ]. Although psychological stress is strongly linked to the disorder, our patient did not report psychological problems other than a second-degree family history of anxiety disorder [ 1 ].…”

“…All of these cases provide insights into the underlying etiology of the disease. Our patient had a history of retinoblastoma as well as neurological symptoms, suggesting that hematohidrosis may be linked to neurological pathology disorders [ 2 , 5 , 6 ]. However, no definitive etiology has been established.…”

Hematidrosis

“…Hematidrosis is an exceedingly rare and peculiar clinical disorder characterized by spontaneous exudation of blood-mixed fluid from the intact skin or mucosa. [ 1 2 ] Though fewer than hundred cases have been reported so far,[ 1 2 3 4 5 ] its mention dates back to the era of Leonardo da Vinci and notably in Bible too. [ 3 ] It has been mainly cited in dermatological texts,[ 1 2 3 ] whereas management involves mostly psychotropics, beta blockers, and psychotherapy.…”