A case of hematidrosis successfully treated with propranolol

We report a typical case of hematidrosis in a Chinese girl who had experienced frequent bleeding episodes for more than 3 years. During hospitalization, spontaneous bleeding from her intact skin was witnessed by our staff on more than 20 occasions. Characteristically, bloody droplets from the intact skin contained all blood components. Histopathologic examination showed some inconspicuous abnormalities, with normal sweat gland structure containing no blood, and bloody exudate also came from some areas that do not contain sweat glands. We believe that the blood was mixed with a sweat-like fluid, rather than real sweat. The patient's bleeding problem was dramatically resolved by treatment with propranolol. We suggest that sympathetic nerve activation might play a role in these events, and that β-adrenoceptor antagonists might be an effective treatment for this disorder.