Bleeding from the eyes and through intact skin: Physiologic, structural, spiritual, or faked?
ABSTRACT Patients with an apparent bleeding disorder can usually be diagnosed by a careful history, physical examination, and screening laboratory tests. However, at times the constellation of bleeding signs and symptoms fail to be explained by test results and/or our current understanding of hemostatic mechanisms. One such patient is the subject of the current report. She is a 13-year-old female with a history of striking bleeding manifestations, including spontaneous hemorrhage from her eyes, scalp, hands, and feet. She was evaluated by one of the authors at a teaching hospital in Mumbai, India in March 2009 during the filming of a National Geographic Channel documentary characterizing puzzling medical disorders encountered in India. Given her unusual bleeding manifestations, she received international media attention at the time. National Geographic and a film company in the United Kingdom subsequently expressed interest in highlighting the patient to document her seemingly rare hematologic disorder and contacted the American Society of Hematology to identify an American hematologist to further investigate the case. With consent of the family and collaboration with a hematologist practicing at a teaching hospital in Mumbai, filming commenced during March 2009 in an attempt to capture the patient's diagnosis and the cultural and medical milieu in which the bleeding events occurred. Am. J. Hematol. 88:713–716, 2013. © 2013 Wiley Periodicals, Inc.
Seminars in Hematology 08/1980; 17(3):192-213. · 2.46 Impact Factor
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ABSTRACT: Cutaneous or subcutaneous endometriosis is a rare entity that should be suspected in any female presenting with cyclic pain emanating from a mass in the vicinity of an abdominal surgical scar or the umbilicus. The purpose of this report is to examine the diagnostic procedures for endometriosis and to review the therapeutic value of surgical excision alone or in combination with hormonal treatment. Endometriosis presenting cutaneously in an infraumbilical laparoscopy scar and endometriosis occurring subcutaneously in a cesarean section scar were both diagnosed via incisional biopsy. Both lesions were treated with hormonal therapy followed by surgical excision. Hormonal therapy with danazol or with leuprolide resulted in reduction of symptoms but was associated with amenorrhea in both cases and with dyspareunia in the second patient. Subsequent laparoscopy and surgical excision of the endometrioma were curative. Preoperative hormonal therapy, although sometimes associated with such side effects as amenorrhea, may be used in cases of large endometriotic masses to reduce the size of the surgical defect, but surgical excision remains the treatment of choice.The Journal of dermatologic surgery and oncology 11/1994; 20(10):693-5.
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ABSTRACT: 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.American Journal of Clinical Dermatology 12/2010; 11(6):440-3. DOI:10.2165/11531690-000000000-00000 · 2.52 Impact Factor