Hematohidrosis induced by separation anxiety disorder during COVID-19 quarantine: a case report and brief literature review


Published: 23 December 2022
Abstract Views: 790
PDF: 286
HTML: 50
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Here, we report a case involving a 10-year-old Vietnamese girl who developed hematohidrosis during the coronavirus disease quarantine. She was hospitalized with a 3-week recurrent bleeding on the abdominal skin. Physical examination revealed no signs of injuries on the skin. Hematological and biochemical test results and coagulation profiles were all within normal ranges. No abnormal findings were observed on abdominal ultrasonography and computed tomography. Numerous erythrocytes were observed during the microscopic examination of fluid samples from the abdominal skin. It was speculated that hematohidrosis was precipitated by separation anxiety disorder, because the onset and remission of symptoms correlated with the beginning and end of the local quarantine, respectively. Our case report and brief literature review highlight the transient and benign nature of hematohidrosis. Although specific guidelines are not well established, hematohidrosis is a transient phenomenon that is treatable with pharmaceutical and non-pharmaceutical interventions, and its overall prognosis is favorable.


Canonical J, Wisuthsarewong W, Chantorn R, et al. Hematidrosis: a pathologic process or stigmata. A case report with comprehensive histopathologic and immunoperoxidase studies. Am J Dermatopathol. 2008;30:135–9. DOI: https://doi.org/10.1097/DAD.0b013e318164cf4b

Bhattacharya S, Das MK, Sarkar S, De A. Hematidrosis. Indian Pediatr. 2013;50(7):703–4. DOI: https://doi.org/10.1007/s13312-013-0178-x

Gião Antunes AS, Peixe B, Guerreiro H. Hematidrosis, Hemolacria, and gastrointestinal bleeding. GE Port J Gastroenterol. 2017;24:301–4. DOI: https://doi.org/10.1159/000461591

Wang Z, Yu Z, Su J, et al. A case of hematidrosis successfully treated with propranolol. Am J Clin Dermatol. 2010;11:440–3. DOI: https://doi.org/10.2165/11531690-000000000-00000

Mora E, Lucas J. Hematidrosis: blood sweat. Blood. 2013;121:1493. DOI: https://doi.org/10.1182/blood-2012-09-450031

Goria C. Cutaneous hemorrhage (hematohidrosis) and fever of psychogenic origin; pathogenetic mechanism. Minerva Med. 1952;43:762–3.

Kluger N. Hematidrosis (bloody sweat): a review of the recent literature (1996–2016). Acta Dermatovenerol Alp Pannonica Adriat. 2018;27:85–90. DOI: https://doi.org/10.15570/actaapa.2018.19

Shafique DA, Hickman AW, Thorne A, et al. Pediatric hematidrosis – A case report and review of the literature and pathogenesis. Pediatr Dermatol. 2021;38:994–1003. DOI: https://doi.org/10.1111/pde.14792

Hoover A, Fustino N, Sparks AO, Rokes C. Sweating blood: A case series of 2 siblings with hematohidrosis. J Pediatr Hematol Oncol. 2021;43:70–2. DOI: https://doi.org/10.1097/MPH.0000000000001661

Favaloro EJ, Lippi G. Commentary: controversies in thrombosis and hemostasis Part 1-Hematidrosis: “Blood, Sweat and Fears” or A “Pigment of Fertile Imaginations?” Semin Thromb Hemost. 2018;44:296–7. DOI: https://doi.org/10.1055/s-0037-1608906

Holoubek JE, Holoubek AB. Blood, sweat and fear. “A classification of hematidrosis”. J Med. 1996;27:115–33.

Mishra KL. Bloody tears and hematohidrosis in a patient of PF3 dysfunction: a case report. Cases J. 2009;2:9029. DOI: https://doi.org/10.4076/1757-1626-2-9029

Jerajani HR, Jaju B, Phiske MM, Lade N. Hematohidrosis – a rare clinical phenomenon. Indian J Dermatol. 2009;54:290–2. DOI: https://doi.org/10.4103/0019-5154.55645

Deshpande M, Indla V, Kumar V, Reddy IR. Child who presented with hematohidrosis (sweating blood) with oppositional defiant disorder. Indian J Psychiatry. 2014;56:289–91. DOI: https://doi.org/10.4103/0019-5545.140649

Uber M, Robl R, Abagge KT, et al. Hematohidrosis: insights in the pathophysiology. Int J Dermatol. 2015;54:e542–3. DOI: https://doi.org/10.1111/ijd.12932

Matsuoka R, Tanaka M. Hematidrosis in a Japanese girl: treatment with propranolol and psychotherapy. Pediatr Int. 2020;62:1001–2. DOI: https://doi.org/10.1111/ped.14223

Yeşilova Y, Turan E, Aksoy M. Hematidrosis on the forehead following trauma: a case report. Int J Dermatol. 2017;56:212–4. DOI: https://doi.org/10.1111/ijd.13274

Murota H, Kotobuki Y, Yamaga K, Yoshioka Y. Female child with hematidrosis of the palm: case report and published work review. J Dermatol. 2020;47:166–8. DOI: https://doi.org/10.1111/1346-8138.15179

Carvalho AC, Machado-Pinto J, Nogueira GC, et al. Hematidrosis: a case report and review of the literature. Int J Dermatol. 2008;47:1058–9. DOI: https://doi.org/10.1111/j.1365-4632.2008.03746.x

Bhagwat PV, Tophakhane RS, Rathod RM, et al. Hematohidrosis. Indian J Dermatol Venereol Leprol. 2009;75:317–8. DOI: https://doi.org/10.4103/0378-6323.51267

Jafar A, Ahmad A. Child who presented with facial hematohidrosis compared with published cases. Case Rep Dermatol Med. 2016;2016:5095781. DOI: https://doi.org/10.1155/2016/5095781

Shahgholi E. A case series of hematohidrosis: A puzzling medical phenomenon. Turk J Pediatr. 2018;60:757–61. DOI: https://doi.org/10.24953/turkjped.2018.06.022

Praveen BK, Vincent J. Hematidrosis and hemolacria: a case report. Indian J Pediatr. 2012;79:109–11. DOI: https://doi.org/10.1007/s12098-011-0449-2

Tshifularo M. Blood otorrhea: blood stained sweaty ear discharges: hematohidrosis; four case series (2001–2013). Am J Otolaryngol. 2014;35:271–3. DOI: https://doi.org/10.1016/j.amjoto.2013.09.006

Maglie R, Caproni M. A case of blood sweating: hematohidrosis syndrome. CMAJ. 2017;189:E1314. DOI: https://doi.org/10.1503/cmaj.161298

Alsermani M, Alzahrani H, El Fakih R. Hematidrosis: A fascinating phenomenon-case study and overview of the literature. Semin Thromb Hemost. 2018;44:293–5. DOI: https://doi.org/10.1055/s-0037-1608905

Corrà A, Quintarelli L, Caproni M. Bleeding from the oral cavity: a new case of hematohidrosis. Int J Dermatol. 2020;59:e421–2. DOI: https://doi.org/10.1111/ijd.15021

Tirthani K, Sardana K, Mathachan SR. Hematohidrosis of the mid-face and hands treated with oral oxybutynin. Pediatr Dermatol. 2021;38:962–3 DOI: https://doi.org/10.1111/pde.14621

Nguyen, H. T., Vo, P. T. D., Nguyen, T. T. D., Nguyen, Q. T., & Truong, D. L. (2022). Hematohidrosis induced by separation anxiety disorder during COVID-19 quarantine: a case report and brief literature review. Dermatology Reports, 15(2). https://doi.org/10.4081/dr.2023.9615

Downloads

Download data is not yet available.

Citations