Peus D, von Schmiedeberg S, Pier A, Scharf RE, Wehmeier A, Ruzicka T, Krutmann J.
Coagulation factor V gene mutation associated with activated protein C resistance
leading to recurrent thrombosis, leg ulcers, and lymphedema: successful treatment
with intermittent compression.
J Am Acad Dermatol 1996 Aug;35(2 Pt 2):306-9

Department of Dermatology, Heinrich-Heine-University, Dusseldorf, Germany.

Activated protein C resistance is the most frequent cause of venous thrombosis. We
describe a patient with extensive ulcerations and severe lymphedema of the legs
after recurrent thrombosis. Laboratory tests revealed a pathologic activated
protein C resistance and a reduced functional protein S. The underlying genetic
defect was identified as a heterozygous coagulation factor V mutation. A combined
therapeutic approach of intermittent compression, repeated debridements and
systemic antibiotics resulted in marked improvement of both lymphedema and leg
ulcers.