Hemorrhagic subcutaneous nodules: an initial clinical sign of hemophilia A.

A 9-month-old boy presented with multiple hemorrhagic subcutaneous nodules after treatment with oral antibiotics for an upper respiratory tract infection. Excessive bleeding after an incisional biopsy led to a diagnosis of hemophilia A. While this was an unexpected presentation of hemophilia, screening laboratory coagulation studies prior to biopsy would have revealed the etiology. Similar presentations should alert dermatologists to suspect an underlying coagulation defect prior to biopsy, thus averting bleeding complications.