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

Manonukul, Jane MD*; Wisuthsarewong, Wanee MD†; Chantorn, Rattanavalai MD†; Vongirad, Akkrarash MD*; Omeapinyan, Piyarat MD*

American Journal of Dermatopathology: April 2008 - Volume 30 - Issue 2 - pp 135-139
doi: 10.1097/DAD.0b013e318164cf4b
Extraordinary Case Report

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.

From the *Department of Pathology; and †Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Reprints: Jane Manonukul, MD, Associate Professor, Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand (e-mail: sijmn@mahidol.ac.th).

© 2008 Lippincott Williams & Wilkins, Inc.