Skin biopsy for the diagnosis of peripheral neuropathy

  • G. L
  • R. L
  • F. C
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Lauria G, Lombardi R, Camozzi F & Devigili G(2009) Histopathology 54, 273-285Skin biopsy for the diagnosis of peripheral neuropathy Skin biopsy has become an accepted tool for investigating small nerve fibres, which are invisible to conventional neurophysiological tests even though they are affected early on in peripheral neuropathies of varying aetiology. Morphometric analysis of epidermal and dermal nerves has proved to be reliable, reproducible and unaffected by the severity of neuropathy, making skin biopsy useful for diagnosing small fibre neuropathy (SFN) in clinical practice. The possibility of obtaining skin biopsy specimens from different sites of the body, to repeat them within the area of the same sensory nerve, to distinguish between somatic and autonomic nerves and to investigate the expression of nerve-related proteins has widened the potential applications of this technique to clinical research. Skin biopsy performed using a minimally invasive disposable punch is a safe and painless procedure. Using specific antibodies with bright-field immunohistochemistry or immunofluorescence technique, it is possible to investigate unmyelinated fibres innervating the epidermis of hairy and glabrous skin, large myelinated fibres supplying specialized corpuscles in glabrous skin, and autonomic fibres innervating sweat glands, blood vessels and arrector pilorum muscles. This review discusses the features of skin innervation in hairy and glabrous skin, the functional properties of skin nerve fibres and their changes in peripheral neuropathies. © 2008 Blackwell Publishing Limited.

Author-supplied keywords

  • *peripheral neuropathy/di [Diagnosis]
  • *skin biopsy
  • Fabry disease/di [Diagnosis]
  • Friedreich ataxia/di [Diagnosis]
  • Guillain Barre syndrome/di [Diagnosis]
  • Human immunodeficiency virus infection
  • Pacini corpuscle
  • Parkinson disease/di [Diagnosis]
  • Sjoegren syndrome
  • adrenergic nerve
  • autonomic nerve
  • bright field microscopy
  • burning mouth syndrome/di [Diagnosis]
  • calcitonin gene related peptide/ec [Endogenous Com
  • cannabinoid receptor/ec [Endogenous Compound]
  • celiac disease
  • clinical practice
  • complex regional pain syndrome type I/di [Diagnosi
  • confocal microscopy
  • congenital analgesia/di [Diagnosis]
  • dermis
  • dermoepidermal junction
  • diabetes mellitus
  • diabetic neuropathy
  • diagnostic value
  • disease severity
  • dopamine beta monooxygenase/ec [Endogenous Compoun
  • dysautonomia/di [Diagnosis]
  • epidermis
  • erythromelalgia/di [Diagnosis]
  • gene product/ec [Endogenous Compound]
  • glabrous skin
  • hair
  • hair follicle
  • hereditary motor sensory neuropathy/di [Diagnosis]
  • histopathology
  • human
  • immunofluorescence
  • immunohistochemistry
  • impaired glucose tolerance
  • minimally invasive procedure
  • morphometrics
  • myelin associated glycoprotein/ec [Endogenous Comp
  • myelin sheath
  • myelinated nerve
  • nerve fiber
  • nerve fiber degeneration
  • nerve fiber regeneration
  • neuropathic pain
  • neuropathy/di [Diagnosis]
  • neuropeptide Y/ec [Endogenous Compound]
  • neurophysiology
  • nonmyelinated nerve
  • oral glucose tolerance test
  • patient safety
  • peripheral myelin protein 22/ec [Endogenous Compou
  • polyradiculoneuropathy/di [Diagnosis]
  • postherpetic neuralgia/di [Diagnosis]
  • priority journal
  • protein antibody/ec [Endogenous Compound]
  • protein expression
  • punch biopsy
  • purinergic receptor/ec [Endogenous Compound]
  • restless legs syndrome/di [Diagnosis]
  • review
  • sarcoidosis
  • sensory nerve
  • sensory neuropathy/di [Diagnosis]
  • skin blood vessel
  • skin nerve
  • somatostatin/ec [Endogenous Compound]
  • substance P/ec [Endogenous Compound]
  • sweat gland
  • sympathetic nerve cell
  • systemic lupus erythematosus
  • tissue fixation
  • transient receptor potential channel/ec [Endogenou
  • vulvodynia/di [Diagnosis]

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  • Lauria G.

  • Lombardi R.

  • Camozzi F.

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