WARNING: Contains Graphic Images
A 21-year-old woman has been diagnosed with an extremely rare condition that causes her to sweat blood from her face and the palms of her hands.
The unidentified woman was admitted to a general medical ward with a three-year history of ‘episodes of bleeding from her palms and face despite no evidence of skin lesions’, according to a case study published in the Canadian Medical Association Journal.
The bizarre episodes, which would last between one and five minutes, caused the woman great distress and utterly confounded doctors, until now.
Dr Roberto Maglie, who co-wrote the paper with Dr Marzia Caproni, said:
There was no obvious trigger for the bleeding, which could occur while she was asleep and during times of physical activity. She stated that more intense bleeding occurred during times of perceived emotional stress.
Our patient had become socially isolated owing to embarrassment over the bleeding and she reported symptoms consistent with major depressive disorder and panic disorder. There was no history of psychosis.
The woman’s doctors treated her subsequent depression and anxiety with medications, paroxetine and clonazepam, but found no evidence to link the uncontrollable bleeding to the patient’s mental state.
The medical professionals quickly ruled out a ‘factitious disorder’ – in other words, a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick or by self-injury.
The discharge of blood-stained fluid from her face and hands had been an ongoing medical ailment for a traumatic three years, and determined to get to the bottom of the problem, doctors put her skin under the microscope during extensive laboratory tests.
They were then able to exclude rare disorders that induce ‘coloured sweat’ secretion, such as chromhidrosis and pseudochromhidrosis, and confirmed that her blood count and blood-clotting functions were normal.
Dr Maglie concluded:
Based on the presence of erythrocytes on microscopic examination we diagnosed hematohidrosis. Hematohidrosis is an uncommon disease characterized [sic] by spontaneous discharge of ‘blood sweat’ through intact skin.
Similar ailments have been reported historically in patients suffering with malaria, scurvy and epilepsy. However, this woman’s mystery continues, thought to affect just one in 10 million people.
Despite the fluid’s sweat-like appearance, the hypothesis that blood passes through eccrine ducts [major bodily sweat glands], induced by abnormal constrictions and expansions of periglandular vessels, has not yet been proven. Bleeding has also reportedly occurred through areas without sweat glands…
But good news for the patient came swiftly after diagnosis: Maglie and Caproni treated her with propranolol, ‘based on its use in similar cases in the literature’, and this led to a marked reduction, although not a complete remission of her bleeding.
In an accompanying commentary, Canadian medical historian and hematologist Jacalyn Duffin said she was at first sceptical over the claims and feared that the Italian doctors had been deceived.
However, after examining medical literature she agreed that though the condition is rare, it is very real.
While little is known about hematohidrosis it is thought that as anxiety increases, the blood vessels which surround the sweat glands constrict to the point of rupture, which push it to the surface of the skin alongside sweat.
Hopefully medical professionals are working out a way to help those who suffer.
If you suffer with anxiety and depression, please don’t do so in silence. Call Samaritans on their free 24-hour hotline, on 116-123.