Atrophie blanche is a skin disorder characterized by recurrent ulceration and fibrosis. It is one of a group of cutaneous vasculitides associated with decreased blood fibrinolytic activity. We examined pre- and post-venous occlusion plasma from eight patients with atrophie blanche for release of vascular (tissue-type) plasminogen activator (t-PA). The average plasma level of releasable t-PA was only 0.03 IU/mL, compared with 0.70 IU/mL for 118 healthy controls. Therefore, the fibrinolytic disorder in atrophie blanche is associated with defective release of t-PA from blood vessel walls.