Spontaneous Ecchymosis as Initial Presentation of Acquired Hemophilia A

Hemophilia A, a deficiency of clotting factor VIII, can be congenital, presenting with joint bleeding in childhood, or acquired, a rare subtype presenting as spontaneous bleeding most commonly seen in older adult patients. This report outlines an older adult patient with no history of bleeding disorders who developed acute-onset spontaneous ecchymoses and was found to have acquired hemophilia A. This case demonstrates the importance of a broad differential diagnosis in ecchymoses in older adult patients that includes coagulation factor deficiencies despite a lack of hematologic history. Early diagnosis and treatment of hemophilia A with hemostatic control and inhibitor eradication are imperative to prevent life-threatening bleeding.