Systematic Review and Meta-Analysis

Skin Appendage Disord 2022;8:179–185 Received: August 26, 2021

Accepted: October 16, 2021
DOI: 10.1159/000520648 Published online: January 3, 2022

Hematohidrosis, Hemolacria, and

“Trichorrhage”: A Systematic Review
Diego Carrion-Alvarez a, b Alejandro I. Trejo-Castro c Mauricio Salas-Garza d
     

Oscar Raul Fajardo-Ramirez d Julio Cesar Salas-Alanis e

   

aDystrophic
Epidermolysis Bullosa Research Association, Guadalupe, Mexico; bBasic Science Department, School
of Health Sciences, Universidad de Monterrey, San Pedro Garza García, Mexico; cSchool of Engineering and
Sciences, Tecnológico de Monterrey, Monterrey, Mexico; dSchool of Medicine and Health Sciences, Tecnológico de
Monterrey, Monterrey, Mexico; eInstituto Dermatológico de Jalisco, Guadalajara, Mexico

Keywords this particular entity and approach to its treatment as well as

Hematohidrosis · Hemolacria · Trichorrhage provide the first trichoscopy image of a patient with hemo-
lacria. © 2022 S. Karger AG, Basel

Abstract
Introduction: Hematohidrosis and hemolacria are 2 condi-
tions surrounded in religiousness, mysticism, and supernat-
ural 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 me-
dian age of apparition was 24 years with the youngest case
being 12 and the oldest 81. Some of the diseases were sec-
ondary to other causes such as hemangiomas and other neo-
plasias 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 pa-
tients such as mucins, metalloproteinases, and fibrinogen, as
well as propose a mechanism that can explain the signs of
Introduction
Hematohidrosis is defined as the sweeting of blood,
while hemolacria is stated as the crying of blood with-
out any clinical explanation such as a surgery. Both
clinical entities are strongly linked to mysticism and
spirituality. The first description of this dermatological
manifestation comes from the Bible, in which is de-
scribed how Jesus of Nazareth appeared the day before
the crucifixion as stated by the evangelist Luke “and be-
ing in anguish he prayed more earnestly, and his sweat
was like drops of blood falling to the ground.” Since
then, this phenomenon has been related to appearance
of stigmas and is often looked like a supernatural phe-
nomenon. Several reports have been published through-
out history, especially during the 18th and 19th centu-

karger@karger.com © 2022 S. Karger AG, Basel Correspondence to:

www.karger.com/sad Alejandro I. Trejo-Castro, a00818219 @ itesm.mx
Table 1. Articles and characteristics of the patients included in the systematic review

Author Year Country Gender Age Hematohidrosis Hemolacria Place of blood sweeting

Bhagwat et al. [5] 2009 India Female 12 X Forehead, umbilical area

Jaju et al. [3] 2009 India Male 72 X Abdomen

Mishra [6] 2009 India Female 13 X X Eyes

Patel and Mahajan [7] 2010 India Male 13 X Face, arm, trunk

Jablenska et al. [8] 2010 United Kingdom Female 39 X Eyes

Praveen and Vincent [9] 2011 India Female 10 X X Face, neck, umbilical, wrists, legs

Özcan et al. [10] 2012 Turkey Female 11 X Eyes

Biswas et al. [11] 2013 India Female 12 X Face, trunk

Dillivan [12] 2013 USA Male 81 X Eyes

Tshifularo [13] 2013 South Africa Female 30 X Ear

Female 26 X Ear
Female 34 X Ear
Female 18 X Ear

Deshpande et al. [14] 2014 India Male 10 X Face

Iovieno et al. [15] 2015 Italy Male 28 X Eyes

Shen et al. [16] 2015 China Female 9 X Canthi, nails, tongue, umbilical area

Uber et al. [17] 2015 Brazil Female 18 X Palms, back of hands, face

Doshi et al. [18] 2015 India Female 10 X Eyes

Fowler et al. [19] 2015 USA Male 16 X Eyes

Female 20 X Eyes

Jafar and Ahmad [20] 2016 Kuwait Female 12 X Eyes

Pujari and Bajaj [21] 2016 India Female 15 X Eyes

Bakhurji et al. [22] 2017 Saudi Arabia Female 4 months X Eyes

Gião Antunes et al. [23] 2017 Portugal Male 66 X Eyes

Jayaraman et al. [24] 2017 India Female 10 X Scalp

Maglie and Caproni [25] 2017 Italy Female 21 X Palms, face

Sobol and Barmettler [26] 2017 USA Female 11 X Eyes

James et al. [27] 2018 India Male 22 X Eyes

Ali and Naik [28] 2018 India Female 35 X Eyes

Di Maria and Fama [29] 2018 Italy Male 52 X Eyes

Khanna et al. [30] 2018 France Female 67 X Eyes

Manzano et al. [31] 2018 USA Male 11 months X Eyes

Shahgholi [32] 2018 Iran Female 11 X Face, umbilical area, vagina, back
Male 8 X Nail, hand, and feet
Female 9 X Face

Ricci et al. [4] 2018 Italy Female 15 X X Eyelids, palms

Das et al. [33] 2019 India Female 15 X X Ears, nose, eyes

Female 13 X X Face, eyes, shoulders, forearm

180 Skin Appendage Disord 2022;8:179–185 Carrion-Alvarez et al.

DOI: 10.1159/000520648
Table 1 (continued)

Author Year Country Gender Age Hematohidrosis Hemolacria Place of blood sweeting

Hansson et al. [34] 2019 Sweden Male 9 X Forehead, neck

Murota et al. [35] 2019 Japan Female 6 X Palms

Pari [36] 2019 India Female 10 X Forehead, chest

Corrà et al. [37] 2020 Italy Female 15 X X Oral cavity

Drake and Packer [38] 2020 USA Male 81 X Eyes

Seethapathy and Jethani [39] 2020 India Male 62 X Eyes

Agrawal et al. [40] 2020 India Female 13 X Eyes

Das et al. [41] 2020 India Female 11 X Eyes

Boffa et al. [42] 2020 Malta Male 11 days X Eyes

Garcia et al. [43] 2020 USA Male 12 X Eyes

Khan et al. [44] 2020 Bangladesh Female 20 X Eyes

Li et al. [45] 2020 USA Male 22 X Eyes

Salas-Alanis et al. [46] 2020 Mexico Male 22 X X Scalp, palms, eyes

AlGoiriani et al. [47] 2021 Saudi Arabia Female 12 X Eyes

Hoover et al. [48] 2021 USA Male 9 X X Gum, eyes, umbilical area, axillae
Female 6 months X X Hairline, ears

Kosałka-Węgiel et al. [49] 2021 Poland Male 18 X Eyes

Idowu et al. [50] 2021 USA Female 21 X Eyes

Nandakumal et al. [51] 2021 Malaysia Male 12 X Eyes

Singh et al. [52] 2021 India Female 60 X Eyes

Tirthani et al. [53] 2021 India Female 13 X Face

Ghosh et al. [54] 2021 India Female 25 X Eyes

ries [1]. However, the first published medical report of Methods

hematohidrosis accessible in PubMed dates from 1918
in the British Medical Journal [2]. In this disease, the
secretion of a blood-like substance is observed in situa-
tions of extreme stress such as facing death [3]. It is a
rare disease, and its mechanism is still unknown, while
the use of some medications like propranolol has re-
ported a clinical benefit in some case reports [4]. A clin-
ical case was previously reported by our colleague Salas-
Alanis et al. in June 2020. Considering the small num-
ber of cases reported so far, we performed a systematic
review of published cases in order to systematize the
current information of this condition.
We performed a systematic search following the PRISMA flow-
chart (online suppl. material; for all online suppl. material, see
www.karger.com/doi/10.1159/000520648). An electronic data-
base search was conducted in PubMed from January 1, 2021, to
July 31, 2021. The words included were “hematohidrosis” OR “he-
molacria” OR “haematohidrosis” OR “haemolacria.” Only case re-
ports and case series were included. Articles on English and Span-
ish were included. The exclusion criteria included inability to find
the full text even after contacting the corresponding author and
lack of information. All duplicates were removed using a citation
manager program.

Hematohidrosis, Hemolacria, and Skin Appendage Disord 2022;8:179–185 181

“Trichorrhage”: A Systematic Review DOI: 10.1159/000520648
 Fig. 1. Action places of the coagulation-al-
tered mechanisms. The figure was created
in the Mind the Graph platform.

a c

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.

Results tears was associated with a systemic disease such as un-

A total of 66 results were found, and after duplica-
tion removal and identification, only 53 articles which
accounted for 60 cases were included. All the articles
can be found in Table 1 [3–54]. From the retrieved ar-
ticles, 20 presented only hematohidrosis while 31 pre-
sented hemolacria and 9 cases presented both manifes-
tations. In some articles, the presence of the bloody
derlying hemangiomas or meningiomas [29, 30]. In
some of the cases, the clinical manifestations appeared
after traumatizing events; however, the magnitude of
these events significantly varied between the cases,
while some patients have been exposed to life threats
[46], witnessed a violent death [5], or outlived a natural
disaster [4], other detonates included familiar conflicts
[18].

182 Skin Appendage Disord 2022;8:179–185 Carrion-Alvarez et al.

DOI: 10.1159/000520648
Table 2. Role of gene-affected factors in coagulation

Component Role Reference

Extracellular matrix The extracellular matrix contains several proteins which activate platelets once the blood vessels become Bergmeier and
damaged; some of those proteins include integrins and fibrinogen; there are also several nonintegrin Hynes et al. [56]
receptors in the matrix that contribute significantly to platelet adhesion
Collagen chains Collagen chains’ role in coagulation has been largely studied, exercising regulatory functions within the Farndale et al.
vasculature. Several types of collagens exist, some of them being responsible for platelet adhesion and [57]
promoting the interaction with coagulation factors
A-disintegrin These molecules discovered from snake venom were later also described in mammals; its role is to adhere to Gieber and
integrins and prevent the platelet inhibition, being responsible for the hemorrhage in snake bite victims Zigrino [61]
Metalloproteinase Similar to disintegrins, they play a role in inhibiting platelet aggregation, which helps to decrease coagulation
and the formation of blood clots
Metallopeptidases The metallopeptidases have also been described in both snake venom and within the human; the role they Das et al. [62]
play is similar to metallopeptidase inhibiting platelet adhesion. However, this one has also been shown to
participate in breast cancer migration or invasion
Integrins Integrins are responsible for regulation in the hemostasis process affecting the endothelial cell contractility Gregg et al.
and barrier as well as modifying the adhesion of platelets [63]
Laminins These are noncollagenous proteins present in the basement membrane of the cells; they interact with the White-Adams
platelets promoting adhesion, activation, and aggregation in the initial steps of hemostasis depending on the et al. [64]
XII factor
Mucins While their most important job is related to the control of mineralization and in the immune response to Shao et al. [65]
certain pathogens, they have also shown a role in coagulation in certain types of cancer such as carcinoma
allowing them to promote thrombosis through the manipulating signaling in neutrophils and platelets
von Willebrand factor This glycoprotein has been identified as a major player in hemostasis since the mid-1950s; its functions include Peyvandi et al.
binding to the FVIII, platelets, and constituents of connective tissue, thus promoting clot formations [60]

From the published cases, the median age was 23.51 years,
with the youngest case being a newborn of only 11 days [42]
and the oldest an 81-year-old patient [38]. The cases were
more predominant in females (65%) than in males (35%).
Most of the cases were reported in India (20/60), USA (10/60),
and Italy (5/60). Only 2 cases have been reported in Latin
America [17, 46] as well as other 2 in Africa [10, 13]. The most
common place of bleeding was the eyes (36), followed by the
face (10) and ears (8), and uncommon places included the feet
[32], eyelids [4], and axillae [48].
Discussion
As we have stated before, hematohidrosis and hemo-
lacria are still diseases that continue to be surrounded by
mystery, mystics, and a certain lack of information about
the fisiopatholgy, leading to an overall lack of under-
standing.
It is important to add up that even when information
is still needed in the mechanisms behind the disease, ge-
netic testing has been performed finding possible patho-
genic mutations in genes related to the extracellular ma-
trix, as well as collagen chains, A-disintegrin, metallopro-
teinase, metallopeptidases, mucins, and von Willebrand
factor. All these components play a role in would healing
and coagulation (shown in Fig. 1). The extracellular ma-
trix provides platelets with proteins necessary for their
activation [55]; collagen chains have been associated with
wound healing since several years, with their role in the
formation of blood clots [56]; A-disintegrin and metal-
loproteinases have an active part in the activation of
platelets [57]. Mucins have been shown to facilitate the
platelet activation by circulating tumor cells in certain
types of cancer thus having an active play in coagulation
as well [58]. Finally, von Willebrand factor is a glycopro-
tein whose part in hemostasia has been described since
the mid-1950s [59]. In-depth functions of these compo-
nents can be found in Table 2 [55, 56, 59–64]. Alterations
like this may explain how the disease works. These condi-
tions both surrounded in mystery and syncretism have a
physiological explanation, characterized by an increase in
heart rate, erythrocytic extravasation in small caliber ves-
sels such as capillaries, and leaking in both sweat glands

Hematohidrosis, Hemolacria, and Skin Appendage Disord 2022;8:179–185 183

“Trichorrhage”: A Systematic Review DOI: 10.1159/000520648
and hair follicles. Furthermore, here we reported the first Conflict of Interest Statement
clinical, biopsy, and trichoscopy images of trichorrhage,
The authors have no conflicts of interest to declare.
a novel medical term that describes the flow of blood from
hair follicles in patients with hematohidrosis (as shown in
Fig. 2). While more research is needed, the genetic insight
Funding Sources
allows us to draft a general picture of the possible path-
ways involved in hemolacria and hematohidrosis. No funding was needed.

Acknowledgment Author Contributions

The figure was created in the Mind the Graph platform. D.C.-A., A.I.T.-C., J.C.S.-A., M.S.-G., and O.R.F.-R.: all 5
worked in the ideation, writing, and corrections of the manuscript.

Statement of Ethics
Data Availability Statement
Ethical approval was not required for this study in accordance
with national guidelines. Written informed consent was obtained All data can be accessed in Table 2.
from the patient for publication of this case report and any accom-
panying images.

References
  1 Duffin J. Sweating blood: history and review.
CMAJ. 2017 Oct 23;189(42):E1315–7.
  2 Scott CT. A case of haematidrosis. BMJ. 1918
May 11;1(2993):532–3.
  3 Jaju B, Phiske M, Lade N, Jerajani H. Hema-
tohidrosis: a rare clinical phenomenon. Indi-
an J Dermatol. 2009;54(3):290.
  4 Ricci F, Oranges T, Novembre E, Della Bona
ML, la Marca G, de Martino M, et al. Haema-
tohidrosis treated with propranolol: a case re-
port. Arch Dis Child. 2019 Feb;104(2):171.
  5 Bhagwat P, Tophakhane R, Rathod R, Shashi-
kumar B, Naidu V. Hematohidrosis. Indian J
Dermatol Venereol Leprol. 2009;75(3):317.
  6 Mishra KL. Bloody tears and hematohidrosis
in a patient of PF3 dysfunction: a case report.
Cases J. 2009;2(1):9029.
  7 Patel RM, Mahajan S. Hematohidrosis: a rare
clinical entity. Indian Dermatol Online J.
2010;1(1):30.
  8 Jablenska L, Lo S, Uddin J, Toma A. Nasolac-
rimal tuberculosis: case report highlighting
the need for imaging in identifying and man-
aging it effectively. Orbit. 2010 Apr 16;29(2):
126–8.
  9 Praveen BK, Vincent J. Hematidrosis and he-
molacria: a case report. Indian J Pediatr. 2012
Jan 27;79(1):109–11.
10 Özcan KM, Özdaş T, Baran H, Ozdogan F,
Dere H. Hemolacria: case report. Int J Pediatr
Otorhinolaryngol. 2013 Jan;77(1):137–8.
11 Biswas S, Surana T, De A, Nag F. A curious
case of sweating blood. Indian J Dermatol.
2013;58(6):478.
12 Dillivan KM. Hemolacria in a patient with se-
vere systemic diseases. Optom Vis Sci. 2013
Jun;90(6):e161–6.
13 Tshifularo M. Blood otorrhea: Blood stained
sweaty ear discharges: hematohidrosis; four
case series (2001–2013). Am J Otolaryngol.
2014 Mar;35(2):271–3.
14 Deshpande M, Indla V, Kumar V, Reddy IR.
Child who presented with hematohidrosis
(sweating blood) with oppositional defiant
disorder. Indian J Psychiatry. 2014;56(3):289.
15 Iovieno A, Coassin M, Piana S, De Luca M,
Giunta P, Fontana L. A case of unilateral he-
molacria. Int Ophthalmol. 2016 Apr 27;36(2):
273–4.
16 Shen H, Wang Z, Wu T, Wang J, Ren C, Chen
H, et al. Haematidrosis associated with epi-
lepsy in a girl successfully treated with oxcar-
bazepine: case report. J Int Med Res. 2015 Apr
11;43(2):263–9.
17 Uber M, Robl R, Abagge KT, Carvalho VO,
Ehlke PP, Antoniuk SA, et al. Hematohidro-
sis: insights in the pathophysiology. Int J Der-
matol. 2015 Dec;54(12):e542–3.
18 Doshi V, Sivalingam D, Nambi S, Varalaksh-
mi B. The story of a girl with weeping blood:
childhood depression with a rare presenta-
tion. Indian J Psychiatry. 2015;57(1):88.
19 Fowler BT, Kosko MG, Pegram TA, Haik BG,
Fleming JC, Oester AE. Haemolacria: a novel
approach to lesion localization. Orbit. 2015
Nov 2;34(6):309–13.
20 Jafar A, Ahmad A. Child who presented with
facial hematohidrosis compared with pub-
lished cases. Case Rep Dermatol Med. 2016;
2016:5095781–4.
21 Pujari A, Bajaj MS. Idiopathic bilateral hae-
molacria. BMJ Case Rep. 2016 Dec 30; 2016:
bcr2016218342.
22 Bakhurji S, Yassin SA, Abdulhameed RM. A
healthy infant with bloody tears: case report
and mini-review of the literature. Saudi J
Ophthalmol. 2018 Jul;32(3):246–9.
23 Gião Antunes AS, Peixe B, Guerreiro H. He-
matidrosis, hemolacria, and gastrointestinal
bleeding. GE Port J Gastroenterol. 2017;
24(6):301–4.
24 Jayaraman AR, Kannan P, Jayanthini V. An
interesting case report of hematohidrosis. In-
dian J Psychol Med. 2017 Jan 1;39(1):83–5.
25 Maglie R, Caproni M. A case of blood sweat-
ing: hematohidrosis syndrome. CMAJ. 2017
Oct 23;189(42):E1314.
26 Sobol EK, Barmettler A. A case of idiopathic
bilateral hemolacria in an 11-year-old girl.
Ophthalmic Plast Reconstr Surg. 2017 Jul;
33(4):e98–9.
27 James R, Bharadhi M, James J. Haemolacria in
a 22-year-old boy. BMJ Case Rep. 2018 Dec
22;11(1):e225151.
28 Ali MJ, Naik MN. Dacryoendoscopy in a case
of unexplained hemolacria. Ophthalmic Plast
Reconstr Surg. 2018 Nov;34(6):e213.
29 Di Maria A, Famà F. Hemolacria: crying
blood. N Engl J Med. 2018 Nov;379(18):1766.
30 Khanna RK, Fontaine A, Lemacon JM,
Moriniere S, Pisella PJ. Hemolacria revealing
a primary nasolacrimal duct melanoma. Can
J Ophthalmol. 2019 Apr;54(2):e70–3.
31 Manzano G, Shantharam R, Webb E, Finelt N,
Hengel K. Case 2: hemolacria, Hematochezia,
and Hematuria in an 11-month-old Boy. Pe-
diatr Rev. 2018 Aug 1;39(8):418–20.
32 Shahgholi E. A case series of hematohidrosis:
a puzzling medical phenomenon. Turk J Pe-
diatr. 2018;60(6):757.

184 Skin Appendage Disord 2022;8:179–185 Carrion-Alvarez et al.

DOI: 10.1159/000520648
33 Das D, Chiranthan M, Meel R, Neupane S.
Crying out blood: haemolacria in a young girl.
BMJ Case Rep. 2020 Jun 17;13(6):e236579.
34 Hansson K, Johansson EK, Albåge M, Ballar-
dini N. Paediatric haematohidrosis: an over-
view of a rare but clinically distinct condition.
Acta Paediatr. 2019 Jun 19;108(6):1023–7.
35 Murota H, Kotobuki Y, Yamaga K, Yoshioka
Y. Female child with hematidrosis of the
palm: case report and published work review.
J Dermatol. 2020 Feb 2;47(2):166–8.
36 Pari T. Hematohidrosis: a rare case. Indian
Dermatol Online J. 2019 May–Jun;10(3):334.
37 Corrà A, Quintarelli L, Caproni M. Bleeding
from the oral cavity: a new case of hematohi-
drosis. Int J Dermatol. 2020 Nov 23; 59(11):
e421–2.
38 Drake AE, Packer CD. Epistaxis complicated
by hemolacria: a case report. Clin Med Res.
2020 Aug 13;18(2–3):99–101.
39 Seethapathy G, Jethani J. Uncontrolled sys-
temic hypertension and haemolacria. Indian
J Ophthalmol. 2020;68(4):638.
40 Agrawal S, TM, Das D, Bajaj MS, Modaboyina
S, Modaboyina V. Tears of blood – a female
adolescent with essential idiopathic bilateral
haemolacria: case report and brief review.
Trop Doct. 2021 Apr 13;51(2):237–40.
41 Das D, Kumari P, Poddar A, Laha T. Bleeding
to life: a case series of hematohidrosis and he-
molacria. Indian J Pediatr. 2020 Jan 16;87(1):
84–.
42 Boffa MM, Spiteri A. Haemolacria: a case of
pseudomembranous conjunctivitis in a neo-
nate. BMJ Case Rep. 2020 Jun 30; 13(6):
e235110.
43 Garcia GA, Bair H, Charlson ES, Egbert JE.
Crying blood: association of valsalva and he-
molacria. Orbit. 2021 May 4;40(3):266–.
44 Khan AW, Khan AA, Ishaq M, Ullah I, Ma-
mun MA. Factitious disorder, presenting hae-
molacria in a Pakistani tribal illiterate female:
a rare case report. Perspect Psychiatr Care.
2021 Jul 26;57(3):1532–5.
Hematohidrosis, Hemolacria, and
“Trichorrhage”: A Systematic Review
45 Li E, Yoda RA, Keene CD, Moe KS, Chambers
C, Zhang MM. Nasolacrimal lymphangioma
presenting with hemolacria. Ophthalmic
Plast Reconstr Surg. 2020 Sep 27;36(5):e118–
22.
46 Salas-Alanis JC, Salas-Garza M, Goldust MM,
Fajardo-Ramirez OR. Haematidrosis and
haemolacria in a young adult. Clin Exp Der-
matol. 2021;46(2):394–6.
47 AlGoraini Y, Şeyhibrahim A, Jawish M. A
healthy young girl crying out blood: a case re-
port. Heliyon. 2021 May;7(5):e07143.
48 Hoover A, Fustino N, Sparks AO, Rokes C.
Sweating blood: a case series of 2 siblings with
hematohidrosis. J Pediatr Hematol Oncol.
2021 Mar;43(2):70–2.
49 Kosałka-Węgiel J, Wawrzycka-Adamczyk K,
Matyja-Bednarczyk A, Siwiec A, Włudarczyk
A, Bazan-Socha S. Hemolacria, epistaxis,
bloody otorrhea, hemoptysis, and hematuria
in an 18-year-old man. Pol Arch Intern Med.
2021 Aug 30;735(736):735–6.
50 Idowu OO, Kaidonis G, Husain S, Winn BJ.
Case report: crying blood. Optom Vis Sci.
2021 Mar;98(3):217–21.
51 Nandakumal G, Ismail F, Mohamad NF, Lott
PW, Chew KS, Ab Rahman S, et al. A rare case
of von willebrand disease presenting as hemo-
lacria and literature review. J Pediatr Hematol
Oncol. 2021 Apr;43(3):101–3.
52 Singh M, Saikia UN, Kaur M, Sharma M,
Gupta P. Lacrimal sac actinomycosis: a mas-
querade of lacrimal sac malignancy. Ophthal-
mic Plast Reconstr Surg. 2021 Mar–Apr 1;
37(2):e45–7.
53 Tirthani K, Sardana K, Mathachan SR. Hema-
tohidrosis of the mid-face and hands treated
with oral oxybutynin. Pediatr Dermatol. 2021
May 26;38(4):962–3.
54 Ghosh S, Tale S, Handa N, Bhalla A. Rare case
of red tears: ocular vicarious menstruation.
BMJ Case Rep. 2021 Mar 9;14(3):e237294.
55 Bergmeier W, Hynes RO. Extracellular matrix
proteins in hemostasis and thrombosis. Cold
Spring Harb Perspect Biol. 2012 Feb 1; 4(2):
a005132.
Skin Appendage Disord 2022;8:179–185
DOI: 10.1159/000520648
56 Farndale RW, Sixma JJ, Barnes MJ, De Groot
PG. The role of collagen in thrombosis and
hemostasis. J Thromb Haemost. 2004 Apr;
2(4):561–73.
57 Facey A, Pinar I, Arthur JF, Qiao J, Jing J,
Mado B, et al. A-disintegrin-and-metallopro-
teinase (ADAM) 10 activity on resting and ac-
tivated platelets. Biochemistry. 2016 Mar 16;
55(8):1187–94.
58 Ganguly K, Rauth S, Marimuthu S, Kumar S,
Batra SK. Unraveling mucin domains in can-
cer and metastasis: when protectors become
predators. Cancer Metastasis Rev. 2020 Sep 2;
39(3):647–59.
59 Peyvandi F, Garagiola I, Baronciani L. Role of
von Willebrand factor in the haemostasis.
Blood Transfus. 2011 May;9(Suppl 2):s3–8.
60 Giebeler N, Zigrino P. A disintegrin and me-
talloprotease (ADAM): historical overview of
their functions. Toxins. 2016 Apr 23;8(4):122.
61 Das K, Prasad R, Ansari SA, Roy A, Mukher-
jee A, Sen P. Matrix metalloproteinase-2: a
key regulator in coagulation proteases medi-
ated human breast cancer progression
through autocrine signaling. Biomed Phar-
macother. 2018 Sep;105:395–406.
62 Gregg D, de Carvalho DD, Kovacic H. Integ-
rins and coagulation: a role for ROS/redox
signaling? Antioxid Redox Signal. 2004 Aug;
6(4):757–64.
63 White-Adams T, Ma B, Patel I, Tucker E,
Gailani D, Gruber A, et al. Laminin promotes
coagulation and thrombus formation in a fac-
tor XII-dependent manner. J Thromb Hae-
most. 2010 Jun 7;8(6):1295–301.
64 Shao B, Wahrenbrock MG, Yao L, David T,
Coughlin SR, Xia L, et al. Carcinoma mucins
trigger reciprocal activation of platelets and
neutrophils in a murine model of Trousseau
syndrome. Blood. 2011 Oct 13;118(15):4015–
23. Available from: https: //ashpublications.
org/blood/article/118/15/4015/29024/Carci-
noma-mucins-trigger-reciprocal-activation-
of.
185