ABSTRACT
This chapter focuses on essential role of the fibrinolytic system. It provides a summary of the clinical and microscopic appearances of the lesion, and its differential diagnosis. The microscopic features of the early stages of atrophie blanche are similar to radiation-induced vasculitis. The microscopic appearances of atrophie blanche differ from leukocytoclastic vasculitis where there is prominent neutrophil leukocyte infiltration and fragmentation, usually without thrombosis. Treatment of atrophie blanche includes local physical protection and pharmacologic alteration of the fibrinolytic system. In 1971 Cunliffe and Menon studied a group of patients with various forms of cutaneous vasculitis, which included subjects with lesions characteristic of atrophie blanche. PAI-1 levels in plasma can be determined both by immunochemical and functional assays. When levels of plasminogen activator inhibitor-1 were measured in the group of patients with atrophie blanche, there was no statistically significant difference from the control group.
