To the Editor.—
Hemophilia is an inherited defect in coagulation characterized by persistent bleeding following trauma. Hemarthrosis represents the most characteristic type of hemorrhage but bleeding also frequently occurs from the mouth, gums, lips, tongue, gastrointestinal tract, lungs, and even intracranially.1,2 The skin may be involved with subcutaneous hemorrhage which spreads rapidly over the body. We are unaware of any report regarding acne as a potential source of bleeding in this disease. Recently, we have done follow-up studies on two brothers with classical hemophilia, one of whom experienced prolonged bleeding into nodular cystic lesions of acne.
Report of a Case
A 17-year-old white boy with a one year history of progressively severe acne involving his face, shoulders, and back was referred to the Acne Clinic of the Hospital of the University of Pennsylvania. The patient also suffered from hemophilia A with a factor VIII level of less than
James J. Leyden, Otto H. Mills. Cystic Acne as a Source of Bleeding in Hemophilia. Arch Dermatol. 1973;107(3):465–466. doi:10.1001/archderm.1973.01620180103039