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Now that we have captured your attention with our “snappy” title, we should apologize if the title suggests we are trivializing a potentially serious, and certainly emotive and controversial topic. Hematidrosis (also called blood sweat), is reported to be a very rare condition inwhich a human “sweats blood.” Hematidrosis is purportedly caused by the rupture of capillaries that feed the sweat glands, causing them to include blood elements in the secreted sweat. The condition most frequently seems to occur at times of substantial physical or emotional stress and fear. In the Christian faith, Jesus is said to have undergone hematidrosis before the crucifixion, during the Agony in the Garden (New Testament; Luke 22:44). Hematidrosishas alsobeenproposedas apossible explanation for “stigmata.” Hematidrosis is a condition that only a portion of medical professionals believe in. Certainly, as a condition, there is both plausibility and plausible deniability, with many alternate explanations, potentially including self-inflicted or other injuries (e.g., Munchausen’s syndrome or Munchausen’s by proxy). Neither of the authors to the current commentary, also guest editors to the current issue of the journal, have ever been personally involved in such a case, although perhaps pertinent, in terms of “similar” physical etiology, wehave seen cases of “skin hemorrhages,” albeit always associated with hemorrhagic conditions, either congenital or acquired. Nevertheless, a proposed case of hematidrosis is described in this issue of the journal,1 and the authors of that case report certainly believe they are describing a case of hematidrosis. This case report was sent to several hematologists for review ahead of publication, and skepticism was expressed, having like us, never seen such a caseduring their careers. Someof the potential differential diagnoses and concerns expressed in these reviews are identified in ►Table 1. Despite this healthy skepticism,wedecided topermit thepublicationof this case in this issue of the journal. The intention here is to permit potential future dialogue not only on hematidrosis but also on other potential controversies in thrombosis and/or hemostasis, as the situationmaypresent in thefuture.Our takeon the topic of hematidrosis follows. A search of the literature uncovers only sporadic publications on the topic, with the search term “hematidrosis” or “haematidrosis” in PubMed uncovering a total of only 22 reports, with an additional report on “hematidrosis” in Russian. Of the total 23 reports, 10 were in a non-English language source, and another 3 appeared in English within Indian journals (i.e., tallying more than half of the total). The majority of the publications appear in dermatological or pediatric journals, with one article published in a psychological journal, and only a single report published in a hematological journal. Among some recent articles were a case published in 2017 involving a 10-year-old girl with mixed anxiety and depressive disorder,2 another case of a young girl with epilepsy who was successfully treated using an antiepileptic drug (i.e., oxcarbazepine) published in 2015,3 and a case published in 2013 in an American Society of Hematology (ASH) Image Bank article.4 No other publication in the hematology literature. Not many publications in English geography journals. Apart from two short (single page) publications in Blood4 and the British Medical Journal (BMJ),5 no publication in a high-impact journal is available. Of further interest, the BMJ report (in a newborn) was published exactly 100 years ago!5 No surprise, then, that hematologists, particularly in developed English geography locations, may not believe hematidrosis to be real. Why is hematidrosis plausible? As mentioned, hematidrosis is reportedly caused by the rupture of capillaries that feed

Commentary: Controversies in Thrombosis and Hemostasis Part 1—Hematidrosis: “Blood, Sweat and Fears” or A “Pigment of Fertile Imaginations?”