血汗症一例

患者男，15岁，颜面、双上肢、指趾、甲沟反复间断出现红色分泌物10月余就诊。就诊前患者因受精神刺激后，颜面部出现红色分泌物，以耳、眼、鼻周为甚，每次发作持续2 ～ 3 min自行停止，并形成凝血痂，间歇期无一定的规律，长则月余，短则10天左右。发作期间每日1 ～ 4次，持续1周左右。局部皮肤不伴有瘙痒、疼痛，擦拭血迹后皮肤无瘀点、瘀斑及创口。发作前患者伴有烦躁、易怒、易激惹等精神症状，偶有兴奋及入睡困难，夜间不发作。多次发作后双前臂、小腿伸侧、指趾、甲周也相继出现同样的红色分泌物，多为单一部位对称性发生，交替出现。汗血涂片与外周血成分一致。诊断为血汗症。实验室、病理组织、投射电镜及影像学检查均无异常发现。该患者以维生素C、复方芦丁片及谷维素治疗，效果均不满意。血汗症是一种少见的疾病，探讨其发病机制是治疗此病的关键。

Hemathidrosis:a case report

A 15-year-old male patient presented with intermittent red secretion on the face, upper limbs, nail grooves, fingers and toes for more than 10 months. Ten months prior to the presentation, red secretions began to emerge on the face, especially ears, eyes and the surrounding area of nose, following a severe psychical stimulus. The attack typically lasted 2 - 3 minutes before spontaneous stop with the formation of blood crusts. The frequency was 1 - 4 per day during the attack of hemathidrosis which might last 1 week. The interval was irregular and varied from 10 days to months. There was no blood stasis, bruise or wound left on the skin after the wipe of bloodstain, and no itch or pain was complained of. Before the secretion of bloody sweat, the patient was always fidgety, irritable, and sometimes excited or difficult to sleep, but the secretion never occurred at night. After several episodes, bloody sweat also appeared in succession and symmetrically on the forearms, extensor crura, fingers, toes and perionychium. The cell components of bloody sweat were identical to those of peripheral blood. The patient was diagnosed as hemathidrosis. No abnormality was found in laboratory tests, histopathological examination, electron microscopy or radiology. No relief of symptoms was achieved after treatment with vitamin C, rutoside and oryzanol. Hemathidrosis is a rare disease, and to clarify its pathogenesis is essential for its treatment.