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11 May 2021

Bleeding from a cut or wound makes sense and is a natural phenomena but , what if your skin bleeds without any injury or wound ?

It sounds senseless right ? But not in the world of science and medicine. This condition do exists and is called HEMATIDROSIS. This condition is very rare and is an enigmatic disorder which is characterised by recurrent episodes of skin bleeding mixed with sweat.The skin bleeds for certain time and stops on it's own. Hardly people know that this condition exists but it has shown it's existance in the history. It is believed that Jesus has sweated blood before crucifixion. There is no particular criteria that who are likely to be attacked by this disorder. This condition may manifest differently in every individual which makes it difficult for the doctor's to research this condition. Only a few handfull hematidrosis cases have been confirmed in the 20th century. Hematidrosis is not associated with any life threatening medical condition , after sometime even without treatment the bleeding stops on its own.

What causes this mysterious condition ?

As this is a very rare condition it's difficult for doctor's to know what actually triggers hematidrosis. They have a thought that it can a fight-or-flight response. The main reason for this condition has been observed to be extreme physical or emotional stress , acute fear , torture , severe ongoing abuse , or facing death. It is also seen in women while they are having periods. Due to these the tiny capillary blood vessels which end up as a network around the sweat glands gets constricted. The blood oozes into the sweat glands , which push it along with sweat to the surface , presenting as droplets of sweat mixed with blood. Severe mental stress activates the sympathetic nervous system to involve the stress-fight-or-flight response to such a point that it causes hemorrhage of the vessels being supplied to the sweat gland. The extravasated blood has identical cell components of the peripheral blood.

Signs and Symptoms involved :

People with hematidrosis sweat blood from their skin. This usually occurs on or around face. In addition the blood oozes from the mucocutaneous surface causing nose bleed , tears of blood (this condition is called hemolacria) , bleeding from ears (this condition is called otorrhea) and vicarious menstruation are common. The extent of blood loss is minimal but may leave the skin fragile and tender. The secreted blood is dilute and appears blood-tinged and in other cases it is thick bright red. These maybe preceeded by intense headache and abdominal pain. The bleeding stops on it's own, it's not serious , but it can make you dehydrate. The skin around the bloody area may swell temporarily.

How can this be diagnosed ?

To figure out what led to this condition the doctor may investigate you with the area of bleeding , how long the bleeding lasts , episodes per day and they try to know to find about your general health. Even after you have been asked to go through liver test , kidney test , CT scan , skin biopsy , platelet aggregation test , coagulation profile, these tests and investigations fail to show any clue on how this has occured.

How can it be treated ?

  • Anti-depressants , anti-anxiety medication may be administered which may give huge relief as extreme phyiscal or emotional stress is a cause.

  • Vitamin C and beta blockers like propranolol 10mg helps lower your blood pressure. The successful use of beta blockers supports the theory that the condition is induced by stress and anxiety yet this etiology is not established.

  • Drugs that improve clott bleeding and stop bleeding can be administered.

  • Counselling and motivating the patient to reduce stress and be calm can be favourable.

  • Psychiatrist visit help the patient have stable mind.

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