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We present a case of a 7-year old patient with the differen-tial diagnosis of hematohidrosis and factitious disorder. Hematohidrosis means sweating blood and is a rare diag-nose. The hypothetical pathophysiology of hematohidrosis is that peripheral blood is secreted through the sweat glands by constriction of the capillary blood vessels around these sweat glands. There is uncertainty whether hemato-hidrosis actually exists. In factitious disorders, which can be imposed on itself or by another person, patients falsify there physical symptoms. In the article, we further explain how the dermatologist can manage a patient with the suspicion on a factitious disorder.