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June 1991

Protein C and Fibrinolysis

Author Affiliations

University of Texas Medical Branch 1405 Marine Dr Galveston, TX 77550

Arch Dermatol. 1991;127(6):909. doi:10.1001/archderm.1991.01680050155024

To the Editor.—  The interesting association of protein C and protein S deficiency to lipodermatosclerosis and venous ulceration was reviewed in the September 1990 issue of the Archives.1 In discussing the function of protein C the authors appropriately state that protein C inactivates coagulation factors V and VIII in their activated form. In their conclusion, they comment that "An increased propensity for deep venous thrombosis, as could occur in the setting of protein C or protein S deficiency and perhaps in combination with a faulty fibrinolytic system, may lead to the development of venous occlusion and venous hypertension."Besides its function in preventing fibrin formation via inhibition of coagulation factors Va and VIIIa,2 activated protein C also serves a profibrinolytic function. Among the many proteins essential for normal fibrinolytic function are the plasminogen activator inhibitors, which prevent the formation of plasmin necessary for fibrinolysis.3 Plasminogen activator inhibitor