Recent developments in the management of peripheral neuropathy using skin biopsy

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Rev Neurol (Paris). 2007 Dec;163(12):1266-70.

Recent developments in the management of peripheral neuropathy using

skin biopsy.

Lauria G.

Neuromuscular Diseases Unit, National Neurological Institute " Carlo

Besta " , Milan, Italy.

Skin biopsy has become a widely used tool to investigate small

calibre nerve fibres in peripheral neuropathies. This technique is

safe, minimally invasive, painless, easy to perform, and cheap. It

provides diagnostic information in patients with small fibre

neuropathy in whom routine neurophysiological tests are commonly

normal. Moreover, it allows investigating the innervation of sweat

glands, thus giving information on the autonomic nervous system.

Biopsy of the hairy skin is used to investigate unmyelinated and

small myelinated fibres, whereas biopsy of the glabrous skin can be

taken to examine large myelinated fibres. The applications of skin

biopsy for diagnostic and research purposes cover the spectrum of

peripheral nervous system diseases, from painful axonal neuropathies

to sensory neuronopathies and immune-mediated and inherited

demyelinated neuropathies.

Finally, studies on axon regeneration in human and experimental

models suggest that skin biopsy has a potential usefulness to monitor

the progression of neuropathy and the efficacy of neuroprotective

treatments.