A rare case of hematohidrosis, hemolacria and epistaxisin an 11-year-old girl

Abstract

Background: Hematohidrosis is an unusual anomaly in which intact skin allows the excretion of blood, with its origin mostly placed on emotional or physical stress. The pathophysiology of hematohidrosis remains mostly unknown. Autonomic dysfunction, microvascular fragility, and capillary rupture are all proposed hypotheses explaining the mechanism of this disorder. This report describes an 11-year-old girl with simultaneous hematohidrosis, hemolacria, and epistaxis, thus contributing to its knowledge and diagnosis together with differential considerations.

Methodology: A retrospective case documentation is done with due permission and informed consent. Clinical details: these were obtained through history-taking and clinical examination. Laboratory workup including complete blood count, coagulation profile, and factor assays. Liver function tests were performed, and a computed tomography (CT) of the brain was done to exclude intracranial pathology. Slit-lamp examination was done for ocular involvement. No therapeutic or follow-up was done—this report serves as a clinical discussion.

Results: The patient having irregular intermittent episodes of hematohidrosis, hemolacria, and epistaxis, all hematological, biochemical, and radiological workups were normal with the only exception of mild ethmoid sinusitis and over-pneumatization of the mastoid air cells on CT scan.

Conclusion: This case shows diagnostic difficulties because of the absence of systemic abnormalities. Further studies should be performed to identify these biomarkers, neurohormonal influences, and potential treatment options, combining expertise from dermatology, neurology, and psychoneuroimmunology to achieve a clinical objective.