PAINFUL BRUISING SYNDROME SKIN
7 – 9 Shortly thereafter in 1928, 2 other cases were described with associated hysterical personality and delusions, respectively, thus connecting the skin lesions with psychopathology. 6 He suggested a possible link to hypnosis, corroborated in a few subsequent case reports, in causing or relieving these lesions. In 1927, the German psychiatrist Rudolf Schindler described 16 patients with skin hemorrhages. The history of psychogenic purpura dates back to the early 20th century. While frequency is highest in women, cases in men and adolescents have also been described. Numerous somatic complaints may be explored in a diagnostic setting without objective findings and with potential history of multiple surgical procedures.
Development generally follows severe stress or emotional trauma or is comorbid with certain psychiatric psychopathology. 1 Manifestation usually occurs via spontaneous development of painful edematous skin lesions, predominantly in the extremities, which may be isolated or multiple, progressing to ecchymosis over the next 24 hours.
Psychogenic purpura is regarded primarily as an autoimmune vasculopathy with sensitization to phosphatidylserine, a component of erythrocyte stroma. Psychogenic purpura, also known as Gardner-Diamond syndrome or autoerythrocyte sensitization syndrome, is an extremely rare condition typically noted in women with psychiatric comorbidity. ■ The role of stress in psychogenic purpura should not be ignored. ■ Proper diagnosis of psychogenic purpura could save many unnecessary procedures. Psychosomatics 41: 279–281.■ Psychogenic purpura could produce a diagnostic dilemma and thus requires thorough investigation. Dissociative Identity Disorder Presenting With Psychogenic Purpura. Stress, Stigmatization and Psychosomatic Purpuras. "Autoerythrocyte sensitization a form of purpura producing painful bruising following autosensitization to red blood cells in certain women". Journal of the European Academy of Dermatology and Venereology. "Autoerythrocyte sensitization syndrome (Gardner-Diamond syndrome): review of the literature**".
Because of the rarity of the disorder, there are few methods of support in place for patients. Patients with this condition can suffer frequent painful bruising around joints and muscles. : 829 It is characterized by a distinctive localized purpuric reaction occurring primarily on the legs, face and trunk, with recurring painful ecchymoses variably accompanied by syncope, nausea, vomiting, gastrointestinal and intracranial bleeding. Painful bruising syndrome (also known as " autoerythrocyte sensitization", " Gardner–Diamond syndrome", and " psychogenic purpura") is an idiopathic trauma-induced condition seen in young to middle-aged women who sometimes manifest personality disorders. Medical condition Painful bruising syndrome