Autoerythrocyte sensitization is a rare disorder affecting women. It is characterized by local pain and burning preceding painful ecchymoses that occur primarily on the extremities.
Autoerythrocyte sensitization typically occurs in white women who are experiencing emotional stress or who have concomitant psychologic illness. Episodes of ecchymosis are painful and can occur spontaneously or after trauma or surgery. Bruising can occur on different sites of the body from where the trauma occurs. Tests of the coagulation system are normal.
In women with autoerythrocyte sensitization, intradermal injection of 0.1 mL of autologous RBCs or RBC stroma may result in pain, swelling, and induration at the injection site. This result suggests that escape of RBCs into the tissues is involved in the pathogenesis of the lesion. However, most patients also have associated severe psychoneurotic symptoms. In addition, psychogenic factors, such as self-induced purpura, seem related to the pathogenesis of the syndrome in some patients.
Diagnosis is based on examination of the site of intradermal injection of autologous RBCs and of a separate control injection site (without RBCs) 24 to 48 h after injection. Excoriation, which can complicate the test's interpretation, is prevented by making both sites difficult for the patient to reach.
Treatment is psychiatric intervention and therapy.
Last full review/revision October 2012 by David J. Kuter