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The utility of skin biopsy for prediction of progression in suspected small fiber neuropathy

From Beth Israel Deaconess Medical Center (C.H.G., I.B.), Boston, MA; and Johns Hopkins Hospital (J.W.G., M.P., A.B., P.H., J.C.M.), Baltimore, MD.

Address correspondence and reprint requests to Dr. Christopher H. Gibbons, Autonomic and Peripheral Nerve Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, MA 02215; e-mail: cgibbons{at}bidmc.harvard.edu.

Twenty-eight patients with sensory complaints of unknown etiology had repeated skin biopsies. Patients with large nerve fiber swellings on initial biopsy showed a decline in epidermal nerve fiber density on repeated biopsies (p < 0.05 within group; p < 0.05 vs those without swellings). Patients without nerve fiber swellings did not have changes in nerve fiber density between biopsies. Patients with large nerve fiber swellings were most likely to present clinically with paresthesias (p < 0.05).

Supported by grants NS44807, RR00522, NS049465 (J.C.M.), NS049899 (C.H.G.).

Disclosure: The authors report no conflicts of interest.

Received March 1, 2005. Accepted in final form October 5, 2005.

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