血汗症的临床及实验室研究——一例报告及文献复习

Clinical and laboratory study of a case of hematidrosis

目的 提高对血汗症的认识 ,探讨其发病机制。方法 报告 1例特发性血汗症的临床及实验室特征 ,同时取患者皮肤标本进行病理及透射电镜检查。结果 血汗症皮肤出血呈发作性 ,出血部位不固定 ,皮肤表面溢出物所含成分与外周血一致。除束臂试验阳性外 ,其他多种出凝血指标检查均阴性。病理及电镜检查可见皮内出血 ,表现和部分毛细血管闭塞 ,汗腺、毛囊和皮脂腺结构正常。结论 血汗症是一罕见的皮肤出血性疾病 ,可能是一种特殊表现的血管炎。

Objective To study the clinical characteristics and pathogenesis of hematidrosis. Methods Detailed clinical manifestations and natural history of a patient with hematidrosis were presented. A series of laboratory examinations were performed,and skin pathohistologic features and ultra microscopic structures were observed. Results The episodes of skin bleeding occurred on any site of the body spontaneously and promptly. The skin surface bloody extravasation has identical cell components as that of peripheral blood. All the results of laboratory tests were normal except a positive Trousseau's test. Skin pathohistological study revealed some intradermal bleeding and emphraxised capillaries. No abnormality was found in sweat glands,hair follicles and sebaceous glands. Conclusion The pathological basis for hematidrosis might be a distinctive vasculitis.