Assessment of epidermal nerve fibers: a new diagnostic and predictive tool for p

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J Neuropathol Exp Neurol. 2007 Dec;66(12):1059-73.

Assessment of epidermal nerve fibers: a new diagnostic and predictive

tool for peripheral neuropathies.

Ebenezer GJ, Hauer P, Gibbons C, McArthur JC, Polydefkis M.

Department of Neurology, s Hopkins University, Baltimore,

land 21287-7609, USA.

Today, skin biopsies can play an important role in the diagnosis of

peripheral nerve disorders and have yielded another diagnostic tool

for the neurologist. One of the commonly reported neuropathologic

abnormalities observed in skin biopsies is a reduction of epidermal

nerve density.

Analyzing the changes in the morphology and density of epidermal

nerves is of immense diagnostic and prognostic value in peripheral

neuropathies. These changes also provide an assessment of disease

progression and of tissue responses to regenerative treatments.

Combined with immunohistochemical studies, newly evolved skin biopsy

and epidermal count techniques have the potential to provide

significant information about the pathogenesis of many peripheral

nervous system diseases. They have great potential for impacts on

both research and clinical approaches to treatment.

Evolution of a standardized and validated counting methodology and

significant advances in procuring skin biopsies have opened up a wide

spectrum of applications that make the technology easy to apply in

practice. The application of this technology may lead to early

detection of many common peripheral nerve diseases and an enhanced

understanding of disease onset and progression. In this article we

review the state of current research and clinical practice in the use

of skin biopsies and epidermal nerve densities.