Hematohidrosis

Hematohidrosis is a rare condition characterized by blood oozing from intact skin and mucosa. Signs and symptoms include sweating blood, crying bloody tears, bleeding from the nose, bleeding from the ears, or oozing blood from other skin surfaces. The episodes are usually self-limiting. In some cases, the fluid appears to be blood tinged, while others resemble frank blood. It can occur on any part of the body, but most commonly appears on the face (ear, nose, and eyes). The cause is unknown. The bleeding is due to the rupture of the very small blood vessels of the skin (dermal capillaries). Some theories include increased vascular pressure leading to the passage of blood cells through the ducts of the sweat glands, inflammation of the vessels of the skin (vasculitis of dermal vessels), and intensified sympathetic activation. Some cases are associated with systemic disease, bleeding disorders, menstruation, excessive exertion, high blood pressure, fear and intense emotional stress. Treatment remains a challenge, and may include vitamin C, hemostatic drugs, anxiolytics, or antidepressants, and propranolol. Resolution of symptoms may occur spontaneously.