Kluger Nicolas
Department of Dermatology, Allergology, and Venereology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
Acta Dermatovenerol Alp Pannonica Adriat. 2018 Jun;27(2):85-90.
Hematidrosis is an eccrine sweat disorder characterized by one or more episodes of spontaneous, bloody sweating from non-traumatized skin. The author carried out a systematic review of all cases of hematidrosis reported in PubMed over the past 20 years. A total of 25 cases were reviewed; 21 were women (84%), the median age was 13 years (range 9-72), and the majority (62%) were from Asia, mainly India. Hematidrosis was located on the face-including the forehead (40%), eyes (40%), and ears (36%)-in 96% of the cases and on the umbilicus in 24% and the palms in 20%. Prodromal symptoms were reported by almost 30% of the patients. Possible triggering factors were identified in 56% of the cases; most of these (86%) were stress factors within families (conflicts or abuse) or at school. In two cases, platelet dysfunction and epilepsy were suspected as culprits. Nine patients had a psychiatric diagnosis associated with hematidrosis. The outcome was favorable in most of the cases with medical treatment (e.g., beta-blocker, anxiolytics) and psychological support. The number of cases has increased in recent years. Hematidrosis appears to be a somatization disorder that mainly affects children from developing countries. Its physiopathology remains largely unknown. It deserves better recognition because it is usually a temporary condition when managed properly.
血汗症是一种外分泌汗腺疾病，其特征为非创伤性皮肤出现一次或多次自发性血性出汗。作者对过去20年PubMed上报道的所有血汗症病例进行了系统综述。共审查了25例病例；其中21例为女性（84%），中位年龄为13岁（范围9 - 72岁），大多数（62%）来自亚洲，主要是印度。96%的病例血汗症位于面部，包括前额（40%）、眼睛（40%）和耳朵（36%），24%位于脐部，20%位于手掌。近30%的患者报告有前驱症状。56%的病例确定了可能的触发因素；其中大多数（86%）是家庭（冲突或虐待）或学校的压力因素。在两例中，怀疑血小板功能障碍和癫痫是病因。9例患者有与血汗症相关的精神科诊断。大多数病例通过药物治疗（如β受体阻滞剂、抗焦虑药）和心理支持后预后良好。近年来病例数量有所增加。血汗症似乎是一种主要影响发展中国家儿童的躯体化障碍。其生理病理学在很大程度上仍然未知。由于妥善处理时它通常是一种暂时的病症，因此值得更好地认识。
