Circulating Factor VIII Anticoagulant in Bullous Dermatitis

A circulating anticoagulant as the cause of a prolonged clotting time was described in 1906 by Weil.¹ An excellent review of this subject has recently appeared in which anticoagulants against Factors I, V, VII, VIII, IX, XI, and XII have been defined.² They have been reported in a variety of diseases including systemic lupus erythematosus, dysproteinemias, liver disease, and penicillin and transfusion reactions as well as generalized skin diseases. Two cases of dermatitis herpetiformis^3,4 and 2 cases of pemphigus vulgaris^5,6 were found to have an anticoagulant against an unspecified factor in the first stage of clotting. A fifth case of a vesiculobullous eruption⁷ was found to have an anticoagulant against tissue thromboplastin. We wish to report a case of generalized bullous dermatitis associated with an anticoagulant against Factor VIII (antihemophilic globulin). We are unaware of any previous case report of a specific anticoagulant against Factor