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. 2022 May;8(3):179-185.
doi: 10.1159/000520648. Epub 2022 Jan 3.

Hematohidrosis, Hemolacria, and "Trichorrhage": A Systematic Review

Diego Carrion-Alvarez  1   2 , Alejandro I Trejo-Castro  3 , Mauricio Salas-Garza  4 , Oscar Raul Fajardo-Ramirez  4 , Julio Cesar Salas-Alanis  5
Affiliations

Hematohidrosis, Hemolacria, and "Trichorrhage": A Systematic Review

Diego Carrion-Alvarez et al. Skin Appendage Disord. 2022 May.

Abstract

Introduction: Hematohidrosis and hemolacria are 2 conditions surrounded in religiousness, mysticism, and supernatural superstitions. While the mechanism is still unclear, these cases have amazed physicians for centuries.

Methods: We performed a systematic review in PubMed from 2000 to mid-2021 accounting for 75 studies from which we included 60 cases in 53 articles which were described.

Results: The median age of apparition was 24 years with the youngest case being 12 and the oldest 81. Some of the diseases were secondary to other causes such as hemangiomas and other neoplasias or epistaxis episodes. Most of the cases have been reported in India and the USA; most of them correspond to hemolacria alone (51.6%).

Discussion: We have stated the basics of the substances involved in the coagulation process that have been described as genetically altered in some patients such as mucins, metalloproteinases, and fibrinogen, as well as propose a mechanism that can explain the signs of this particular entity and approach to its treatment as well as provide the first trichoscopy image of a patient with hemolacria.

Keywords: Hematohidrosis; Hemolacria; Trichorrhage.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Action places of the coagulation-altered mechanisms. The figure was created in the Mind the Graph platform.
Fig. 2
Fig. 2
a Trichorrhage starting from the scalp that bleeds down to the cheek. b Trichoscopy: localized bleeding around the hair follicle forming small ponds. c Arrow shows erythrocytic clusters located in the stratum corneum from hair skin.
See this image and copyright information in PMC

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