Supplementary Material for: Hematohidrosis, Hemolacria, and “Trichorrhage”: A Systematic Review

<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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%). <b><i>Discussion:</i></b> 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.

引言：血汗症（Hematohidrosis）与血性泪溢症（hemolacria）是两种长期被宗教色彩、神秘主义及超自然迷信所笼罩的病症。尽管其发病机制至今尚未明确，但数百年来这类病例始终令临床医师深感诧异。
方法：本研究对2000年至2021年中期PubMed数据库中的文献开展系统回顾，共检索到75项相关研究，最终纳入53篇文献中报道的60例病例进行分析。
结果：病例首次发病的中位年龄为24岁，年龄最小者为12岁，最大者为81岁。部分病例继发于其他疾病，如血管瘤、其他肿瘤或鼻出血发作。多数病例报道来自印度与美国；其中仅表现为血性泪溢症的病例占比51.6%。
讨论：本研究阐明了凝血过程中涉及的物质基础——部分患者体内的黏蛋白、金属蛋白酶及纤维蛋白原已被证实存在基因异常；同时提出了可解释该特殊病症临床表现的潜在发病机制，并对其治疗方案进行了探讨，此外还首次提供了血性泪溢症患者的毛发镜（trichoscopy）图像。