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Author: Dr Duncan Lyons, Resident Medical Officer, Gold Coast University Hospital, Gold Coast, Queensland, Australia. Medical Editor: Dr Helen Gordon, Auckland, New Zealand. DermNet Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. July 2020.

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What is haematohidrosis?

Haematohidrosis is characterised by self-limiting sweating of blood from intact skin. Patients may suffer from recurrent episodes [1].

Haematohidrosis (US spelling hematohidrosis) may also be called haemidrosis (hemidrosis).

Who gets haematohidrosis?

Haematohidrosis is rare.

What causes haematohidrosis?

The cause of haematohidrosis is unknown. It has been associated with periods of stress or anxiety [2,3]. It has been suggested that the peripheral blood reaches the skin’s surface through the sweat glands or hair follicles [3].

What are the clinical features of haematohidrosis?

Haematohidrosis has been reported to occur at several different sites on the body simultaneously. The amount of bleeding is typically small. It has been reported to involve the ears (blood otorrhoea), eyes (tear ducts), limbs, trunk, palms, and soles [1–5].

What is the differential diagnosis of haematohidrosis?

The differential diagnosis of haematohidrosis includes [1]:

How is haematohidrosis diagnosed?

The diagnosis of haematohidrosis may be difficult due to its episodic nature. Investigations may include [2]:

  • A skin biopsy immediately following a bleeding episode
  • The benzidine test, which detects the presence of haemoglobin in the blood, forming a blue/green colour
  • Full blood count, coagulation tests, and a vasculitis screen
  • A psychiatry referral to explore a possible psychogenic cause or trigger.

What is the treatment and prognosis of haematohidrosis?

Reported treatments include [1,4,5]:

  • Anxiolytics
  • Beta-blockers (propranolol)
  • Antidepressants.

Overall, the prognosis for hematohidrosis is good, as it is usually self-limiting [3].

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Related information



  1. Bhattacharya S, Das M, Sarkar S, De A. Hematidrosis. Indian Pediatr 2013; 50: 703-4. Journal
  2. Holoubek J, Holoubek A. Blood, sweat and fear. “A classification of hematidrosis”. J Med 1996; 27: 115–33. PubMed
  3. Patel R, Mahajan S. Hemetohidrosis: a rare clinical entity. Indian Dermatol Online J 2010; 1: 30–2. DOI: 10.4103/2229-5178.73256. PubMed Central
  4. Manonukul J, Wisuthsarewong W, Chantorn R, Vongirad A, Omeapinyan P. Hematidrosis: a pathologic process or stigmata — a case report with comprehensive histopathologic and immunoperoxidase studies. Am J Dermatopathol 2008; 30: 135–9. DOI: 10.1097/DAD.0b013e318164cf4b. PubMed
  5. Uber M, Robi R, Abagge K, Carvalho V, Ehlke P, Antoniuk S. Hematohidrosis: insights in the pathophysiology. Int J Dermatol 2015; 54: 542–3. DOI: 10.1111/ijd.12932. PubMed

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