Venous ulceration of the lower leg is a common and distressing problem which can be very difficult to treat. It is usually caused by a failure of the calf muscle pump which leads to venous hypertension. When prolonged, this can result in capillary proliferation and pericapillary deposition of fibrin1 which probably impairs oxygen diffusion.2 The skin becomes eczematous, pigmented and painfully indurated (so-called lipodermatosclerosis), and ulceration may follow. Fibrinolytic activity in blood and tissue is also impaired in patients with venous hypertension.3 A drug which could promote fibrinolysis might therefore help. The anabolic steroid stanozolol (Stromba - Sterling) enhances fibrinolysis; the manufacturer claims that it prevents the development of new ulcers and reduces the incidence of re-ulceration. Does it really do this?
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