Hematidrosis: Pathophysiology and Therapeutic Strategy

Background: Hematidrosis is an extremely rare and mysterious disorder. The etiology and pathophysiology of this disorder remain mostly unknown, and there is no specific therapeutic strategy available up to now.Methods: The clinical features, hemostatic and other laboratory tests, and bloody exudates of seven patients were investigated, and histologic examination of the affected skin was performed. They were treated with a new therapeutic regimen. Results: The bleeding episodes could appear under different conditions, but often following physical or emotional stress, with some prodromes. The frequency and amount of bleeding varied with each individual. The effluent bloody samples showed all the components of the peripheral blood, mingled with a few epithelial cells. Histologic examination of the affected skin showed normal sweat glands containing no blood. Each of patients was treated individually, and a multi-drug "cocktail therapy" regimen mainly consisting of beta-receptor blocker, anxiolytic, and histamine H1/H2 receptor antagonists proved successful. Although most patients could relapse within 6 to 12 months, the treatment was still effective and they were finally cured. Conclusion: nervous system-hypothalamus-autonomic nervous system pathway in association with histaminergic activation. A multi-drug "cocktail therapy" in accordance to this hypothesis would become a new effective regimen.