Livedoid vasculopathy is characterized by recurrent painful ulceration of t
he feet, ankles and legs that heals with residual white atrophic scars. For
many years, livedoid vasculopathy has been considered to be a primary vasc
ulitic process. Recently, however, there has been a trend towards consideri
ng livedoid vasculopathy as an occlusive vasculopathy due to a hypercoagula
ble state. Livedoid vasculopathy (under the designation livedo vasculitis)
was first reported to be associated with protein C deficiency in 1992. We d
escribe an additional patient with livedoid vasculopathy associated with he
terozygous protein C deficiency. This second reported case suggests that pr
otein C deficiency may be one cause of the hypercoagulable condition in the
se patients and demonstrates the necessity for further investigation of thr
ombogenic factors underlying the disease.