10-year-old girl with “blood sweat” phenomenon

At the Annual Scientific Conference of the City Dermatology Association. The 18th Ho Chi Minh City Conference in 2022 was organized by the HCM City Dermatology Hospital in collaboration with the Ho Chi Minh City Dermatology Association on April 24, 2022, BS.CK1 Nguyen Thi Diem Trinh – Clinical Department 1 – City Dermatology Hospital. HCM reported an extremely rare case.

October 2021, City Dermatology Hospital. Ho Chi Minh City received a case of a 10-year-old girl living in Binh Duong province who was brought to the doctor by her father with the reason that about 3 weeks ago, the skin in the abdomen had “bleeding” episodes with dull abdominal pain.

Through examination, the doctors determined that the baby had the phenomenon of “blood sweat” – this is an extremely rare phenomenon, in the past 25 years, the world medical literature has only recorded about 25 cases, the disease has been diagnosed. proved to be related to psychological factors, mental stress.

Taking the medical history, the baby’s father said that around September 2021, the skin of the baby’s abdomen had “bleeding” episodes even though there were no injuries. “Initially, the baby bleeds 1-2 times a day, each time loses about 0.2 to 0.5 ml of blood, lasts about 10 seconds and stops bleeding on its own without any treatment.

The frequency of bleeding and the amount of blood lost per bleed increase gradually. Besides, the baby often complains of dull abdominal pain, crying.

The family took the baby to many hospitals for examination but could not find the cause of the disease. All tests such as complete blood count, coagulation bilan, abdominal ultrasound and abdominal CT scan did not reveal any abnormality.

Image of bleeding in the abdomen of a baby girl.

“Through history taking, clinical examination and other indications, the baby’s health is completely normal. At this point we think about the phenomenon of “sweat blood”.

Dr. Trinh said this is an unknown phenomenon, but according to world literature, the disease is related to factors of nervous tension, anxiety, fear, severe and prolonged stress.

When stressed, it activates the sympathetic nervous system, dilating the blood vessel network around the sweat glands.

If the blood vessels dilate to the extent that red blood cells can pass through the blood vessels and into the sweat glands, blood sweat occurs.

In this case, the patient after a long period of social isolation due to the Covid-19 epidemic also had to experience certain psychological disturbances.

The child expressed sadness, asking to sleep with his parents (even though he has been used to sleeping separately since the age of 5). For an objective assessment, we took the baby to see a psychologist – psychiatrist, and was diagnosed with separation anxiety disorder in children.

The patient was then psychologically treated with sedatives and behavior modification. After 2 weeks the condition improved.

Besides, the social distancing status due to the Covid-19 epidemic has also been eased, the child can go out to play and interact with friends more, so by the end of December 2021, the baby has completely stopped bleeding and cold. The dull stomach ache is no more.

Hematohidrosis is very rare. The clinical manifestation of this phenomenon is sweat secretion mixed with blood. In the light form, the sweat is pale pink, especially the forehead, back, abdomen…

In severe form, blood mixed with sweat flows on some areas of the body’s skin, can flow from the face, nostrils, mouth… even tears are bloody.

According to Dr. Diem Trinh, the phenomenon of sweating blood is generally benign, transient and the disease can be self-limited. The most important thing is to detect and treat comorbidities, and reduce stress, anxiety, stress with medication or psychotherapy.

K.Chi