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
Newman C. Protein C and Fibrinolysis. Arch Dermatol. 1991;127(6):909. doi:10.1001/archderm.1991.01680050155024
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