Diapedesis leading to hematidrosis due to abrupt emotional suffering (Review)

Anyfantakis,Dimitrios; Tsoucalas,Gregory; Karelis,Andreas; Papazoglou,Nikolaos; Spandidos,Demetrios A.; Krasagakis,Konstantinos; Symvoulakis,Emmanouil

doi:10.3892/etm.2024.12743

Diapedesis leading to hematidrosis due to abrupt emotional suffering (Review)

Authors:
- Dimitrios Anyfantakis
- Gregory Tsoucalas
- Andreas Karelis
- Nikolaos Papazoglou
- Demetrios A. Spandidos
- Konstantinos Krasagakis
- Emmanouil Symvoulakis
View Affiliations

Affiliations: Primary Health Care Centre of Kissamos, 73134 Chania, Greece, Department of History of Medicine and Deontology of Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece, Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece, Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71004 Heraklion, Greece, Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece, Department of Dermatology, School of Medicine, University of Crete, 71003 Heraklion, Greece, Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
Published online on: October 11, 2024 https://doi.org/10.3892/etm.2024.12743
Article Number: 453
Copyright: © Anyfantakis et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

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.

View Figures

View References

1	Kluger N: Hematidrosis (bloody sweat): A review of the recent literature (1996-2016). Acta Dermatovenerol Alp Pannonica Adriat. 27:85–90. 2018.PubMed/NCBI
2	Manonukul J, Wisuthsarewong W, Chantorn R, Vongirad A and Omeapinyan P: Hematidrosis: A pathologic process or stigmata. A case report with comprehensive histopathologic and immunoperoxidase studies. Am J Dermatopathol. 30:135–139. 2008.PubMed/NCBI View Article : Google Scholar
3	Whitney DW (ed): The Century Dictionary and Cyclopedia. The Century Co., New York, NY, 1889.
4	Alsermani M, Alzahrani H and El Fakih R: Hematidrosis: A fascinating phenomenon-case study and overview of the literature. Semin Thromb Hemost. 44:293–295. 2018.PubMed/NCBI View Article : Google Scholar
5	Duffin J: Sweating blood: History and review. CMAJ. 189:E1315–E1317. 2017.PubMed/NCBI View Article : Google Scholar
6	Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al: The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 29(n71)2021.PubMed/NCBI View Article : Google Scholar
7	Aristotle: Animal History [Historia animalium, ed. P. Louis, Aristote. Histoire des animaux], vols. 1-3. Les Belles Lettres, Paris, 1:1964; 2:1968; 3:1969: 1:1-157; 2:1-155; 3:1-145, 156-175. Lib. 1-4 (486a5-538b23): vol. 1. Lib. 5-7 (538b28-588a12): vol. 2. Lib. 8-10 (588a16-633b8, 633b12-638b36): vol. 3, 1876.
8	Louis P (ed): Aristotle: On the Animal Parts [De partibus animalium. Les parties des animaux]. Les Belles Lettres, Paris, pp1-166, 1956.
9	Wimmer F (ed): Theophrastus Phil: Fragments [Fragmenta, Theophrasti Eresii opera, quae supersunt, omnia]. Didot, Paris, pp364-410, pp417-462, 1866.
10	Diodorus Siculus: Library [Bibliotheca Historica]. Georgiadis, Athens, 2010.
11	Kühn CG (ed): Pseudo-Galenus: Works [De utilitate respiration & De humoribus liber]. Vol 19. Knobloch, Liepzig, pp485-496, 1830.
12	Marcus Annaeus Lucanus: Pharsalia [M. Annaei Lucani Pharsalia]. Bell, London, p348, 1827.
13	Luce: The Gospel of Luce by Howard Marshall. Wm. B. Eerdmans Publishing, Grand Rabids, 1978.
14	Pooley JH: Bloody Sweat. The Popular Science Monthly, Appleton and Company, New York, NY, 1885.
15	Millingen JG: Curiosities of Medical Experience Revised and Considerably Augmented. Richard Bentley, London, 1839.
16	Gray CJ: The Biblical Museum. Elliot Stock, London, 1871.
17	Parrot J: Study on blood sweat and neuropathic hemorrhages [Étude sur la sueur de sang et les hémorrhagies névro-pathiqués]. Bulletin De l'Enseignement Médicale, pp633-635, 1859.
18	Hart WP: On Bloody Sweat. The London Medical Record: A Review of the Progress of Medicine, Surgery, Obstetrics and the Allied Sciences. Smith, London, 1875.
19	Moore J: Index-catalogue of the library of the surgeon-general's office. United States Army. U.S. Government Printing Office, Washington, DC, 1889.
20	Banberger H, Foerster A and von Scanzoni F: Stahel's book and art negotiation [Wurzburger Medichinische Zeitschrift]. Stahelschen Buch und Kunstverhandlung, Wurzburg, 1864.
21	Casper JL: Weekly Medical Magazine, Editorial [Wochenschrift fur die gesammte Heilkunde]. August Hirschwald, Berlin, 1848.
22	Hoffmann FA: Textbook of Constitutional Diseases [Lehrbuch der Constitutionkrankheiten]. Von Ferdinand Enke, Stuttgart, 1893.
23	Von Franque O and Geigel A: Medical-Surgical Monas Booklets [Medicinisch-chirurgische Monashefte]. Kritisches Sammeljournal fur praktische Heilkunde. Von Ferdinand Enke, Jahrgang, 1863.
24	Spörlin G: Letter [1627], in Wilhelm Fabricius Hildanus. In: Works [Opera quæ extant omni]. Johannis Beyeri, Frankfurt, p601, 1646.
25	Ledelius S: Library of the Medical Treasure of Practice [Bibliotheca medico-practica sive rerum medicinarum thesaurus etc.]. Manget JJ (ed). Vol 4. Chouet and Ritter, Geneva, p592, 1697.
26	Dyer I: A Case of Hematidrosis Combined with Chromidrosis. The Medical News, Brighton, pp702-703, 1895.
27	Wood JC: A text-book of gynecology. Boericke and Tafel, Philadelphia, 1894.
28	Virchow RLC: Professor Virchow on Louise Lateau. The Medical Times and Gazette: A Journal of Medical Science, Literature, Criticism, and News, p507, 1874.
29	Tittel M: A Case of Hematidrosis. The Medical Record: A Monthly Journal of Medicine and Surgery, p142, 1876.
30	Chambers TK: A case of bloody sweat. Lancet. 1:205–209. 1861.
31	Servaes F: About blood sweating on the head in Dementia paralytica [Ueber Blutschwitzen am Kopfe de Dementia paralytica]. Centralblatt fur die Medicinischen Wissenschaften. August Hirschwald, Berlin, 1863.
32	Westphal A: Bloody Sweat [De Sudore Sanguineo] (Baldinger sylloge t. II). Gryphisw, 1775.
33	Fabre A: Pathogenesis of the Neuro-Diseases [Les relations pathogéniques des troubles nerveux]. Delahaye, Paris, 1880.
34	Nevis Hyde J: A Practical Treatise On the Diseases of the Skin. Leo Brothers, Philadelphia, PA, 1893.
35	Anderson M: Lectures on Clinical Medicine. MacMillan and Co, London, 1877.
36	Berheim S and Laurent E: Practical Treatise on Clinical and Therapeutic Medicine [Traité Pratique de Médecine Clinique et Thérapeudique]. Maloine, Paris, 1895.
37	Dechambre A: Encyclopedic Dictionary of Medical Sciences [Dictionnaire Encyclopédique des Sciences Médicales]. Asselin & Masson, Paris, 1871.
38	Van Harlingen A: Haematidrosis (Bloody Sweat). International clinics volume II. Lippincott, Philadelphia, PA, 1896.
39	Ziegler E: General pathology, The science of the causes, nature and course of the pathological disturbances which occur in the living subject. W. Wood and Company, New York, NY, 1895.
40	Shoemaker JV: Geranium Maculatum in Nelson E.M. Saint Louis Courier of Medicine Volume XIX. Chambers, Mississippi, MS, 1888.
41	Kapozi M: Pathology and Treatment of Diseases of the Skin. W. Wood & Company, New York, NY, 1895.
42	Scott CT: A case of Haematidrosis. Br Med J. 2993:532–533. 1918.PubMed/NCBI View Article : Google Scholar
43	Holoubek JE and Holoubek AB: Blood, sweat and fear. A classification of hematidrosis. J Med. 27:115–133. 1996.PubMed/NCBI
44	Zheng J, Bian MR, Wu XQ, Xiao Y, Chen YH, Shen R, Feng C and Gao KB: Hematidrosis: A case report. Dermatol Ther. 35(e15462)2022.PubMed/NCBI View Article : Google Scholar
45	Alasfoor S, Albashari M, Alsermani A, Bakir M, Alsermani M and Almustanyir S: A strange occurrence of hematohidrosis: A case report from Saudi Arabia. Cureus. 14(e21682)2022.PubMed/NCBI View Article : Google Scholar
46	Bhattacharya S, Das MK, Sarkar S and De A: Hematidrosis. Indian Pediatr. 50:703–704. 2013.PubMed/NCBI View Article : Google Scholar
47	Shafique DA, Hickman AW, Thorne A, Elwood HR and Zlotoff BJ: Pediatric hematidrosis-A case report and review of the literature and pathogenesis. Pediatr Dermatol. 38:994–1003. 2021.PubMed/NCBI View Article : Google Scholar
48	Mora E and Lucas J: Hematidrosis: Blood sweat. Blood. 121(1493)2013.PubMed/NCBI View Article : Google Scholar
49	Carvalho AC, Machado-Pinto J, Nogueira GC, Almeida LM and Nunes MB: Hematidrosis: A case report and review of the literature. Int J Dermatol. 47:1058–1059. 2008.PubMed/NCBI View Article : Google Scholar
50	Praveen BK and Vincent J: Hematidrosis and hemolacria: A case report. Indian J Pediatr. 79:109–111. 2012.PubMed/NCBI View Article : Google Scholar
51	Bhagwat PV, Tophakhane RS, Rathod RM, Shashikumar BM and Naidu V: Hematohidrosis. Indian J Dermatol Venereol Leprol. 75:317–318. 2009.PubMed/NCBI View Article : Google Scholar
52	Varalakshmi B, Doshi VV, Sivalingam D and Nambi S: The story of a girl with weeping blood: Childhood depression with a rare presentation. Indian J Psychiatry. 57:88–90. 2015.PubMed/NCBI View Article : Google Scholar
53	Talwar M, Chidambaram AC, Mekala S, Parameswaran N and Delhikumar CG: Haematohidrosis in a 12-year-old boy: Blood, sweat and tears. Paediatr Int Child Health. 41:300–302. 2021.PubMed/NCBI View Article : Google Scholar
54	Hansson K, Johansson EK, Albåge M and Ballardini N: Paediatric haematohidrosis: An overview of a rare but clinically distinct condition. Acta Paediatr. 108:1023–1027. 2019.PubMed/NCBI View Article : Google Scholar
55	Antunes AS, Peixe B and Guerreiro H: Hematidrosis, hemolacria, and gastrointestinal bleeding. GE Port J Gastroenterol. 24:301–304. 2017.PubMed/NCBI View Article : Google Scholar
56	Jerajani HR, Jaju B, Phiske MM and Lade N: Hematohidrosis-a rare clinical phenomenon. Indian J Dermatol. 54:290–292. 2009.PubMed/NCBI View Article : Google Scholar
57	Techasatian L, Waraasawapati S, Jetsrisuparb C and Jetsrisuparb A: Hematidrosis: A report with histological and biochemical documents. Int J Dermatol. 55:916–918. 2016.PubMed/NCBI View Article : Google Scholar
58	Shahgholi E: A case series of hematohidrosis: A puzzling medical phenomenon. Turk J Pediatr. 60:757–761. 2018.PubMed/NCBI View Article : Google Scholar
59	Wang Z, Yu Z, Su J, Cao L, Zhao X, Bai X, Zhan S, Wu T, Jin L, Zhou P and Ruan C: A case of hematidrosis successfully treated with propranolol. Am J Clin Dermatol. 11:440–443. 2010.PubMed/NCBI View Article : Google Scholar
60	Jafar A and Ahmad A: Child who presented with facial hematohidrosis compared with published cases. Case Rep Dermatol Med. 2016(5095781)2016.PubMed/NCBI View Article : Google Scholar
61	Yeşilova Y, Turan E and Aksoy M: Hematidrosis on the forehead following trauma: A case report. Int J Dermatol. 56:212–214. 2017.PubMed/NCBI View Article : Google Scholar
62	Meyer J, Spacil K, Stehr M, Hinrichs W, Haller S and Schäfer FM: Hematidrosis after head injury-a case report. Klin Padiatr. 231:326–327. 2019.PubMed/NCBI View Article : Google Scholar
63	Tshifularo M: Blood otorrhea: Blood stained sweaty ear discharges: Hematohidrosis; four case series (2001-2013). Am J Otolaryngol. 35:271–273. 2014.PubMed/NCBI View Article : Google Scholar
64	Murota H, Kotobuki Y, Yamaga K and Yoshioka Y: Female child with hematidrosis of the palm: Case report and published work review. J Dermatol. 47:166–168. 2020.PubMed/NCBI View Article : Google Scholar
65	Maglie R and Caproni M: A case of blood sweating: Hematohidrosis syndrome. CMAJ. 189(E1314)2017.PubMed/NCBI View Article : Google Scholar
66	Barankin B, Alanen K, Ting PT and Sapijaszko MJA: Bilateral facial apocrine chromhidrosis. J Drugs Dermatol. 3:184–186. 2004.PubMed/NCBI
67	Nair PA, Kota RKS, Surti NK, Diwan NG and Gandhi SS: Yellow pseudochromhidrosis in a young female. Indian Dermatol Online J. 8:42–44. 2017.PubMed/NCBI View Article : Google Scholar
68	Jayaraman AR, Kannan P and Jayanthini V: An interesting case report of hematohidrosis. Indian J Psychol Med. 39:83–85. 2017.PubMed/NCBI View Article : Google Scholar
69	Shen H, Wang Z, Wu T, Wang J, Ren C, Chen H, Yu Z and Don W: Haematidrosis associated with epilepsy in a girl successfully treated with oxcarbazepine: Case report. J Int Med Res. 43:263–269. 2015.PubMed/NCBI View Article : Google Scholar
70	Uber M, Robl R, Abagge KT, Carvalho VO, Ehlke PP, Antoniuk SA and Werner B: Hematohidrosis: Insights in the pathophysiology. Int J Dermatol. 54:e542–e543. 2015.PubMed/NCBI View Article : Google Scholar
71	Zhang FK, Zheng YL, Liu JH, Chen HS, Liu SH, Xu MQ, Nie N and Hao YS: Clinical and laboratory study of a case of hematidrosis. Zhonghua Xue Ye Xue Za Zhi. 25:147–150. 2004.PubMed/NCBI(In Chinese).
72	Mishra KL: Bloody tears and hematohidrosis in a patient of PF3 dysfunction: A case report. Cases J. 2(9029)2009.PubMed/NCBI View Article : Google Scholar
73	Pari T: Hematohidrosis-A rare case. Indian Dermatol Online J. 10:334–335. 2019.PubMed/NCBI View Article : Google Scholar
74	Patel RM and Mahajan S: Hematohidrosis: A rare clinical entity. Indian Dermatol Online J. 1:30–32. 2010.PubMed/NCBI View Article : Google Scholar
75	Favaloro EJ and Lippi G: Commentary: Controversies in thrombosis and hemostasis part 1-hematidrosis: ‘Blood, Sweat and Fears’ or A ‘Pigment of fertile imaginations?’. Semin Thromb Hemost. 44:296–297. 2018.PubMed/NCBI View Article : Google Scholar
76	Deshpande M, Indla V, Kumar V and Reddy IR: Child who presented with hematohidrosis (sweating blood) with oppositional defiant disorder. Indian J Psychiatry. 56:289–291. 2014.PubMed/NCBI View Article : Google Scholar
77	Biswas S, Surana T, De A and Nag F: A curious case of sweating blood. Indian J Dermatol. 58:478–480. 2013.PubMed/NCBI View Article : Google Scholar
78	Das D, Kumari P, Poddar A and Laha T: Bleeding to life: A case series of hematohidrosis and hemolacria. Indian J Pediatr. 87(84)2020.PubMed/NCBI View Article : Google Scholar
79	Ricci F, Oranges T, Novembre E, Della Bona ML, la Marca G, de Martino M and Filippi L: Haematohidrosis treated with propranolol: A case report. Arch Dis Child. 104(171)2019.PubMed/NCBI View Article : Google Scholar
80	Matsuoka R and Tanaka M: Hematidrosis in a Japanese girl: Treatment with propranolol and psychotherapy. Pediatr Int. 62:1001–1002. 2020.PubMed/NCBI View Article : Google Scholar
81	Tirthani K, Sardana K and Mathachan SR: Hematohidrosis of the mid-face and hands treated with oral oxybutynin. Pediatr Dermatol. 38:962–963. 2021.PubMed/NCBI View Article : Google Scholar
82	Khalid SR, Maqbool S, Raza N, Mukhtar T, Ikram A and Qureshi S: Ghost spell or hematohidrosis. J Coll Physicians Surg Pak. 23:293–294. 2013.PubMed/NCBI
83	Buck AH: A Reference Handbook of the Medical Sciences Embracing the Entire Range of Scientific and Allied Sciences. Vol 3. Wood and Company, New York, NY, 1886.
84	Wilks S: Hematidrosis or Bloody Sweat Complicating Tetanus in Guy's Hospital Reports. Samuel Highley, London, 1872.
85	Kral F and Novak BJ: Veterinary Dermatology. Lippincott, Philadelphia, PA, 1953.
86	Liddel Η and Scott R: Grand Lexicon of the Hellenic Language. Konstantinides, Athens, 1904.
87	Babiniotis G: Lexicon of the New Hellenic Language, 2nd edition. Lexicology Center, Athens, 2002.
88	Favaloro EJ and Lippi G: Commentary: Controversies in thrombosis and hemostasis part 1-hematidrosis: Blood, sweat and fears or a pigment of fertile imaginations? Semin Thromb Hemost. 44:296–297. 2018.PubMed/NCBI View Article : Google Scholar
89	Hoover A, Fustino N, Sparks AO and Rokes C: Sweating blood: A case series of 2 siblings with hematohidrosis. J Pediatr Hematol Oncol. 43:70–72. 2021.PubMed/NCBI View Article : Google Scholar
90	Milne JD: Industrial and Social Position of Women in the Middle and Lower Ranks. Chapman and Hall, London, 1857.
91	Hou CY, Rutherford R, Chang H, Chang FC, Shumei L, Chiu CH, Chen PH, Chiang JT, Miao NF, Chuang HY and Tseng CC: Children's mobile-gaming preferences, online risks, and mental health. PLoS One. 17(e0278290)2021.PubMed/NCBI View Article : Google Scholar
92	Hashemi S, Ghazanfari F, Ebrahimzadeh F, Ghavi S and Badrizadeh A: Investigate the relationship between cell-phone over-use scale with depression, anxiety and stress among university students. BMC Psychiatry. 22(755)2022.PubMed/NCBI View Article : Google Scholar
93	Conrad LI, Neve M, Nutton V, Porter R and Wear A: The Western Medical Tradition: 800 BC to AD 1800. Cambridge University Press, Cambridge, 1995.
94	Valpy E: The new testament with english notes, critical, philological and explanatory. Vol 3. 4th edition. Longman, Baldwin, Whittaker, Rivington and Simpkin, London, 1836.
95	Hesychius: Hesychii Alexandrini Lexicon. Sumptibus Frederici Maukii, Ienae, 1868.
96	Kechichian E, Khoury E, Richa S and Tomb R: Religious stigmata: A dermato-psychiatric approach and differential diagnosis. Int J Dermatol. 57:885–893. 2018.PubMed/NCBI View Article : Google Scholar
97	Del Forno C: Stigmata: From Saint Francis of Assisi to idiopathic. Ann Dermatol Venereol. 141:529–530. 2014.PubMed/NCBI View Article : Google Scholar : (In French).
98	Pilato MM: The memoirs of Dr. Michael Arthur Creed. Xlibris Corporation, 2010.
99	Jestice PG: Holy People of the World: A Cross-Cultural Encyclopedia. ABC-CLIO, Santa Barbara & Denver & Oxford, 2004.
100	Von Gorres JJ: The Stigmata a History of Various Cases. Richardson, London, 1883.