Cutaneous fibrinolytic activity in scleroderma

Fibrinolytic activity is notoriously related to the maintenance of an adequate microcirculatory blood flow and its impairment is related to thrombosis. In this report cutaneous fibrinolytic activity has been evaluated with an autohistographic method in ten subjects with morphea and in five subjects with systemic sclerosis before and after injection of histamine into the skin. Cutaneous fibrinolytic activity (CFA) appeared normal (3/5 cases) or increased (2/5) in uninvolved and involved skin in systemic scleroderma and always increased after histamine injection. In circumscribed scleroderma the CFA appeared reduced in 2/10 cases, normal in 4/10 cases and increased in 4/10 cases. These data show that an endothelial pool of plasminogen activator is available in the skin of scleroderma patients and that fibrinolytic agents can rationally be employed only in certain stages of the disease.