A 54-year old anorectic patient with painful bruising syndrome (Gardner-Diamond 
syndrome) suffered from various gastrointestinal and psychologic complaints. The 
episodes of painful bruising could be provoked following intradermal injection 
of washed red blood cells within 96 h. The pathogenesis of this rare entity is 
more likely due to a psychiatric alteration rather than to the immunological 
mechanisms, as had been postulated two decades ago. Nevertheless, the 
Gardner-Diamond-syndrome should be included in the differential diagnosis of 
ecchymotic bleeding.