Small Fiber Neuropathy: Is Skin Biopsy the Holy Grail?
- Giuseppe LauriaAffiliated withNeuromuscular Diseases Unit, IRCCS Foundation, Carlo Besta Neurological Institute Email author
- , Raffaella LombardiAffiliated withNeuromuscular Diseases Unit, IRCCS Foundation, Carlo Besta Neurological Institute
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Small fiber neuropathy (SFN) is characterized by negative sensory symptoms (thermal and pinprick hypoesthesia) reflecting peripheral deafferentation and positive sensory symptoms and signs (burning pain, allodynia, hyperalgesia), which often dominate the clinical picture. In patients with pure SFN, clinical and neurophysiologic investigation do not show involvement of large myelinated nerve fiber making the diagnosis of SFN challenging in clinical practice. Over the last 15 years, skin biopsy has emerged as a novel tool that readily permits morphometric and qualitative evaluation of somatic and autonomic small nerve fibers. This technique has overcome the limitations of routine neurophysiologic tests to detect the damage of small nerve fibers. The recent availability of normative reference values allowed clinicians to reliably define the diagnosis of SFN in individual patients. This paper reviews usefulness and limitations of skin biopsy and the relationship between degeneration and regeneration of small nerve fibers in patients with diabetes and metabolic syndrome.
KeywordsDiabetic neuropathy Small fiber neuropathy Skin biopsy Neuropathic pain Intraepidermal nerve fibers Dermal nerves Autonomic neuropathy
- Small Fiber Neuropathy: Is Skin Biopsy the Holy Grail?
Current Diabetes Reports
Volume 12, Issue 4 , pp 384-392
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links
- Diabetic neuropathy
- Small fiber neuropathy
- Skin biopsy
- Neuropathic pain
- Intraepidermal nerve fibers
- Dermal nerves
- Autonomic neuropathy
- Industry Sectors