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According to a case study published in the Canadian Medical Association Journal, a 21-year-old Italian woman checked into a medical ward complaining of a strange—and horrifying—symptom: She had been bleeding intermittently from her face and palms for three years, seemingly without cause. Eventually, her doctors reached a rare—and somewhat controversial—diagnosis: Hematohidrosis, or “blood sweating.”

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The 21-year-old patient’s case is consistent with previous cases. She reported that her bleeding could occur at any time, even when she was asleep, lasting from one to five minutes. She also said that it was more intense when she was emotionally distressed. As a result, her social life had suffered. She had isolated herself because of the embarrassment of the condition, and reported symptoms consistent with depression and panic disorder.She was treated with propranolol, a beta-blocker that’s commonly used to regulate blood pressure and heart rate, and while her bleeding didn’t stop entirely, the treatment did lead to a “marked reduction” in symptoms.

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).

Etiology : 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.

History : Cases of the condition date back millennia, as early as the third century BCE, in treatises by Aristotle. It’s said Jesus of Nazarus sweated blood the night before his execution, and Leonard da Vinci reported a case of a soldier who sweated blood before battle.

In 1996, a pair of physicians presented a classification based on 76 cases from the 17th century to 1980.

However, until fairly recently, medical science on the condition has remained noncommittal, according to Jacalyn Duffin, who penned an additional report to accompany the case report. In fact, as late as 2012, the Elsevier Textbook of Dermatology noted that hematohidrosis had not been confirmed by science. There have been more recent cases. Researchers and doctors have submitted reports of a 72-year-old-man with the condition in 2009, a 13-year-old boy in 2010, an 18-year-old woman and 12-year-old girl in 2013.

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