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A 15-year-old girl was referred to our hospital in 2015 with a 3-month history of spontaneous mucocutaneous bleeding. Her clinical history showed she had suffered from a major stressful event (Abruzzo earthquake in 2006).
Initially the bleeding was sporadic, clear and localised to the eyelids, but after a few weeks became darker, more frequent and widespread (figure 1). Before and after the episodes, no signs of wounds or scrapes were observed. The episodes were usually asymptomatic. …
Footnotes
Contributors FR: diagnosed the disease in the girl, assisted the patient, wrote the first draft of the manuscript and approved the final manuscript as submitted. TO: participated in the clinical assistance of the patient, and reviewed and approved the final manuscript as submitted. EN: participated in the clinical assistance of the patient and approved the final manuscript as submitted. MLDB: contributed to propranolol measurements, contributed to drafting of the manuscript and approved the final manuscript as submitted. GM: responsible for propranolol measurements, contributed to drafting of the manuscript and approved the final manuscript as submitted. MM: participated in the clinical assistance of the patient, and reviewed and approved the final manuscript as submitted. LF: participated in the clinical assistance of the patient, and drafted and approved the final manuscript as submitted.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.