Itching always preceded the appearance of a new flow.
There was no dermal change that could be noticed.
Fullerton mentions a girl of thirteen who had occasional oozing of blood from her brow, face, and the skin under the eyes.

Sometimes a pound of clots was found about her face and pillow.

The blood first appeared in a single clot, and, strange to say, lumps of fleshy substance and minute pieces of bone were discharged all day.

This latter discharge became more infrequent, the bone being replaced by cartilaginous substance.

There was no pain, discoloration, swelling, or soreness, and after this strange anomaly disappeared menstruation regularly commenced.