Usefulness of Skin Biopsies in the Evaluation and Management of Patients with Suspected Small Fiber Neuropathy

ABSTRACT

Objective: To assess the usefulness of skin biopsy in the assessment of patients with suspeted small fiber neuropathy (SFN). Methods: Retrospective chart review of patients with sensory symptoms or findings restricted to small nerve fibers and normal nerve conduction studies (NCS) seen in a subspecialty neuromuscular private practice. Results: Assessments were made on 145 patients. Skin biopsy was abnormal in at least one site in 86 patients (59%). There was no significant difference between patients with normal or abnormal skin biopsies with respect to age, gender, or duration of symptoms. Compared to patients with normal skin biopsies, patients with confirmed SFN were significantly more likely to have pain and were more than twice as likely to respond to standard neuropathic pain medications. Conclusions: Skin biopsy is useful in the diagnosis and management of patients with otherwise unexplained sensory symptoms or findings.

KEYWORDS: :

• intraepidermal nerve fiber density
• small fiber neuropathy
• usefulness