Q: 42 year old female is admitted to ICU with suicidal ideation. ER physician requests ICU bed as he noticed large painful bruises all over the body. Labs were reported normal. In ICU, psychiatric consult was obtained and they come up with the diagnosis of Gardner-Diamond syndrome?


Answer: Gardner-Diamond syndrome is a form of psychogenic purpura, which has taken various names like "hysterical" bleeding, religious stigmata, autoerythrocyte sensitization and painful bruising syndrome. This is typically associated or followed by a psychiatric illness, hard to explain and with essentially normal labs. Physical exam is consist of unexplained painful ecchymotic lesions, mostly on the extremities and/or the face.


References:

1. GARDNER FH, DIAMOND LK. Autoerythrocyte sensitization; a form of purpura producing painful bruising following autosensitization to red blood cells in certain women. Blood 1955; 10:675.

2. Ivanov OL, Lvov AN, Michenko AV, et al. Autoerythrocyte sensitization syndrome (Gardner-Diamond syndrome): review of the literature. J Eur Acad Dermatol Venereol 2009; 23:499.