Hematidrosis constitutes a rare imposing phenomenon encountered millennia ago. It involves the plexus of small, mostly superficial arteries, veins and sweat glands of various parts of the human body. Bloody sweat implies skin pathology. It has been connected to psychogenic impairment and lacks a clear etiology. The present study conducted a historical review using the Thesaurus Linguae Graecae®, Gallica-BNF and Google Books databases. The year 1900 was the mark for full-text works to be included. A second review of the modern literature, over the last 20 years, was carried out using the PubMed/MedLine database. In both eras, the terms h[a]emat[h]idrosis, diapedesis, sudor sanguineus, plus various others vocables of Hellenic and Latin origin, were used as key words. Cases of persons suffering hematidrosis during stigmata as partly connected to this study were surveyed and discussed separately. References were obtained from the classical Greece, late Hellenic antiquity and Roman era. A number of 70 cases were registered from the Renaissance to 1900, and 44 cases between 2007 and 2022. The later time interval is considered as the selection of references of all time, while the 1870 to 1884 interval followed. Differences in sex were observed (males, 60.6%; and females, 39.4%; vs. males, 25.6%; and females, 74.4%). The scalp, forehead, face, trunk, arms and legs were the most common areas of appearance in both time intervals. The eyes and ears were the most common areas of appearance in the modern era. As regards the limitations of the present review, it should be emphasized that not all historical cases were available for survey. Stigmata were studied independently. Records in etiology hypothesis, pathological description and the manifestation of a cluster of post-triggering effects described were similar over time. The modern way of life, major stressful events, a fear of death, hematological disorders, vessel derangements and deep faith may trigger hematidrosis. This spectacular acute event stimulates alertness in patients, family, caregivers and physicians, and may lead to social isolation and unnecessary diagnostic and/or therapeutic interventions. The present narrative review aimed to connect science with history and religion, promote contemplation among health professionals and highlight a medical peculiarity. An open mind is warranted in order to comprehend phenomena in religion. Education for the family and a knowledge update for health professionals is also necessary.

Hematohidrosis is a rare clinical disorder characterized by oozing blood from intact skin and mucous membranes in the absence of a bleeding disorder. Most of the cases reported are from Asia. Although etiopathogenesis is unclear, it has been strongly linked to psychological stress. A nine-year-old girl was brought to the hospital with multiple episodes of painless bleeding from her nose and mouth for four days and eyes for three days, lasting four to five minutes each. Her symptoms and a thorough but unrevealing workup, including brain imaging, led to a clinical diagnosis of hematohidrosis, with parental disharmony as the underlying stress factor. Family therapy was recommended, and parent management training regarding the positive and negative reinforcement techniques was given. A significant improvement was observed at her one-month follow-up. This case adds to the current limited literature on hematohidrosis, highlighting its association with psychological stress and the importance of a multidisciplinary approach to management. Future research is warranted to elucidate molecular pathways involved in stress-induced vascular dysfunction and explore targeted therapeutic interventions.

Hematohidrosis (bloody sweat) is a symptom of trophic damage to the vascular wall, in which sweat mixes with blood and seeps onto undamaged areas of the skin in the form of red or pink liquid (depending on the ratio of sweat to blood). In our study we have analyzed 25 case reports of hematohidrosis in children, reported throughout the world using PubMed, ResearchGate with detailed description and opened access. We took into consideration: age of the patient, sex, location of bloody excretion, cause or trigger, treatment and its effectiveness. Our clinical case present a 9-year-old girl complained of a periodic bleeding from the intact skin of the face, neck, thighs (without visible damage to the skin) manifested by red or pink liquid, nosebleeds, and bloody discharge from the mucous membrane of the eyes. The secretions were of varying intensity and lasted up to several hours. Most of all episodes are associated with a strong emotional exertion. One of the theories of hematohidrosis pathogenesis is evident vasoconstriction of the blood vessels surrounding the sweat glands, provoked by hyperactivation of the sympathetic nervous system, which is followed by their excessive vasodilation up to rupture and blood entering the sweat gland ducts. Capillary endothelial cells are known to contain β2-adrenoceptors, which, through the modulation of nitric oxide release, cause endothelium-dependent vasodilation. Blocking β-adrenoceptors (for example, propranolol) prevents excessive vasodilation of blood vessels and, accordingly, their rupture and blood flow to the sweat gland. We managed to find out that the patient's bloody sweat was a manifestation of a separate pathological phenomenon, and not one of the symptoms of another disease. A properly formed treatment complex and the great trust of the parents enabled to stabilize the child's condition, and later to cure her. Currently, hematohidrosis is recognized as an independent disease that requires in-depth study of the triggering mechanisms of development, pathogenetic and clinical features.

Hematohidrosis is an extremely rare condition characterized by the oozing or secretion of blood through intact skin and mucosa, particularly through eccrine glands. Although there is not much literature available on the condition, examples of Hematohidrosis include the crying and sweating of blood. The fluid may have a bloody tinge or may be frank blood. The anomaly has no identifiable etiology, and patients generally present in a good state of health. In this report, we present a 19-year-old female who had weekly occurrences of bloody diaphoresis that had been present consistently for one year. During her presentation at the hematology clinic, she was investigated thoroughly for alternative causes, but none were found. The patient was diagnosed with hematohidrosis and was offered treatment with propranolol, which she declined. She continues to follow up routinely in the hematology clinic with persistent symptoms.