Psychogenic purpura (Gardner-Diamond syndrome) is the occurrence and spontaneous 
recurrence of painful ecchymosis following emotional stress and minor trauma. 
Although the exact mechanism of this syndrome remains unknown, apart from skin 
lesions, different types of hemorrhaging have been reported, such as epistaxis, 
gastrointestinal bleeding, and bleeding from the ear canals and eyes. We report 
a psychogenic purpura case that presented with hematuria in addition to skin 
lesions. Based on the psychiatric evaluation she was diagnosed with major 
depressive disorder, generalized anxiety disorder, and obsessive-compulsive 
disorder. Additionally, sexual pain disorder accompanied these disorders. With 
the help of antidepressant and supportive psychotherapy, the patient's 
ecchymosis and bleeding disappeared. During 8 months of follow-up the symptoms 
did not return. Vaginismus has not been reported in patients with psychogenic 
purpura. The presence of vaginismus, which is seen more frequently in eastern 
cultures and is thought to be related to sociocultural determinants, suggests 
that some cultural factors may be common to both psychogenic purpura and 
vaginismus. The aim of this case report was to call attention to a syndrome that 
is rarely seen and diagnosed, and to discuss its relationship to psychosocial 
factors. This syndrome should be considered in the differential diagnosis of not 
only ecchymotic lesions, but also various types of bleeding, including 
hematuria. Despite the fact that its etiology and treatment are not clearly 
understood, it should be noted that psychological factors play a role in this 
disease and therefore, psychopharmacological and psychotherapeutic approaches 
can be effective.