BACKGROUND Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa,typically occurring in response to severe emotional stress.Although its exact pa...BACKGROUND Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa,typically occurring in response to severe emotional stress.Although its exact pathophysiology remains unclear,the condition is thought to involve sympathetic nervous system overactivation and capillary fragility,leading to blood extravasation via sweat glands or hair follicles.AIM To evaluate the efficacy and safety of beta-blockers,particularly propranolol,in the management of hematidrosis.METHODS A systematic literature search was conducted in January 2024 across six major databases to identify studies published between 2014 and 2024 that reported the use of beta-blockers in patients with hematidrosis.Eligible studies included clinical case reports or case series that described beta-blocker treatment outcomes.Data were synthesized narratively in accordance with the PRISMA 2020 guidelines.RESULTS Twenty studies met the inclusion criteria.Among them,propranolol was the most frequently prescribed beta-blocker and was associated with symptomatic improvement in over 75%of cases.Some studies also reported enhanced outcomes when beta-blockers were used in conjunction with psychotherapy.Reported adverse effects were minimal,and treatment was generally well-tolerated.However,the available evidence remains limited to low-level observational data,mostly case reports and small case series.CONCLUSION Beta-blockers,especially propranolol,appear to be an effective and well-tolerated treatment option for hematidrosis,particularly in stress-induced presentations.Despite promising findings,the evidence base is constrained by the lack of high-quality studies.Future research should focus on prospective,controlled trials to establish standardized diagnostic and treatment protocols for this rare condition.展开更多
BACKGROUND Hematidrosis is a sporadic disease,to a point where its existence is still denied up to date.It is also linked to stigmata,psychological roots,and religious beliefs,whih has strengthened clinicians'disb...BACKGROUND Hematidrosis is a sporadic disease,to a point where its existence is still denied up to date.It is also linked to stigmata,psychological roots,and religious beliefs,whih has strengthened clinicians'disbelief in hematidrosis.AIM To conduct a thorough review to classify the likelihood of hematidrosis cases.METHODS We searched PubMed,Science Direct,Medline,and Google Scholar,as well as four different preprint databases,including Medrxiv,Research Square,SSRN,and Biorxiv.We included studies from 1996 onwards,with no limitation on language.Hematidrosis was classified as"unlikely","likely",and"highly likely".RESULTS There are 74 articles with 106 hematidrosis cases.India(n=40)and China(n=11)report the most cases.Patients are mostly female(76.5%)with a median age of 13 years.The head region is the most common bleeding site(n=168/254).Headaches(26.9%)and abdominal pain(16.4%)are the most common prodromes.Beta-blockers(43%)and anxiolytic(23.2%)are the most commonly prescribed pharmacotherapy.Psychotherapy(37.5%)and counseling(32.5%)are the most utilized non-pharmacotherapy measures.Only 41.1%and 19.8%of all cases reach complete resolution and are highly likely to be hematidrosis,respectively.CONCLUSION Although hematidrosis is rare and the pathophysiology is still largely unknown,that does not mean hematidrosis does not exist.It is important to note that the most frequent trigger factors are either anxiety,fear,or excessive stress.Clinicians need to exclude other diagnoses and search for stressors to alleviate the bleeding.展开更多
文摘BACKGROUND Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa,typically occurring in response to severe emotional stress.Although its exact pathophysiology remains unclear,the condition is thought to involve sympathetic nervous system overactivation and capillary fragility,leading to blood extravasation via sweat glands or hair follicles.AIM To evaluate the efficacy and safety of beta-blockers,particularly propranolol,in the management of hematidrosis.METHODS A systematic literature search was conducted in January 2024 across six major databases to identify studies published between 2014 and 2024 that reported the use of beta-blockers in patients with hematidrosis.Eligible studies included clinical case reports or case series that described beta-blocker treatment outcomes.Data were synthesized narratively in accordance with the PRISMA 2020 guidelines.RESULTS Twenty studies met the inclusion criteria.Among them,propranolol was the most frequently prescribed beta-blocker and was associated with symptomatic improvement in over 75%of cases.Some studies also reported enhanced outcomes when beta-blockers were used in conjunction with psychotherapy.Reported adverse effects were minimal,and treatment was generally well-tolerated.However,the available evidence remains limited to low-level observational data,mostly case reports and small case series.CONCLUSION Beta-blockers,especially propranolol,appear to be an effective and well-tolerated treatment option for hematidrosis,particularly in stress-induced presentations.Despite promising findings,the evidence base is constrained by the lack of high-quality studies.Future research should focus on prospective,controlled trials to establish standardized diagnostic and treatment protocols for this rare condition.
文摘BACKGROUND Hematidrosis is a sporadic disease,to a point where its existence is still denied up to date.It is also linked to stigmata,psychological roots,and religious beliefs,whih has strengthened clinicians'disbelief in hematidrosis.AIM To conduct a thorough review to classify the likelihood of hematidrosis cases.METHODS We searched PubMed,Science Direct,Medline,and Google Scholar,as well as four different preprint databases,including Medrxiv,Research Square,SSRN,and Biorxiv.We included studies from 1996 onwards,with no limitation on language.Hematidrosis was classified as"unlikely","likely",and"highly likely".RESULTS There are 74 articles with 106 hematidrosis cases.India(n=40)and China(n=11)report the most cases.Patients are mostly female(76.5%)with a median age of 13 years.The head region is the most common bleeding site(n=168/254).Headaches(26.9%)and abdominal pain(16.4%)are the most common prodromes.Beta-blockers(43%)and anxiolytic(23.2%)are the most commonly prescribed pharmacotherapy.Psychotherapy(37.5%)and counseling(32.5%)are the most utilized non-pharmacotherapy measures.Only 41.1%and 19.8%of all cases reach complete resolution and are highly likely to be hematidrosis,respectively.CONCLUSION Although hematidrosis is rare and the pathophysiology is still largely unknown,that does not mean hematidrosis does not exist.It is important to note that the most frequent trigger factors are either anxiety,fear,or excessive stress.Clinicians need to exclude other diagnoses and search for stressors to alleviate the bleeding.
