Systematic review of hematidrosis: Time for clinicians to recognize this entity

Figure 5 Postulated pathophysiology of hematidrosis. There are several hypotheses in hematidrosis pathophysiology. The vasculitis in the dermal vessels, exacerbated by sympathetic activation related to extreme stress and anxiety, leads to periglandular vessel constriction, and subsequent expansion, allowing the blood content to seep into the sweat ducts. Another theory states that multiple blood vessels around the sweat glands are arranged in a net-like form. It is believed that under tremendous stress, the vessels contract. Once anxiety passes, the blood vessels dilate to the point of rupture. The blood, at this point, goes into the sweat glands, which push the blood to the surface and manifests as droplets of blood mixed with sweat. RBCs: Red blood cells.