Recurrent Ecchymoses and Cutaneous Hyperreactivity to Hemoglobin: A Form of Autoerythrocyte Sensitization

A patient with recurrent painful ecchymoses was presented with features similar to those described for patients with autoerythrocyte sensitization. This patient differed in that she was reactive to the red cell hemolysate and purified hemoglobin and not to red cell lipid, red cell stroma, or leukocyte DNA. No evidence was found to support the hypothesis that the abnormal vascular reaction involved an immunologic mechanism. The patient was observed forcibly inducing bruises but not manipulating the skin tests. It was concluded that a cutaneous hyperreactivity to hemoglobin in association with psychological disturbances was responsible for the painful ecchymoses in this patient.