title: Uses of skin biopsy for sensory and autonomic nerve assessment.
abstract: Skin biopsy is a valuable diagnostic tool for small-fiber-predominant neuropathy by the quantification of intraepidermal nerve fiber density (IENFD). It has the unique advantage of being a minimally invasive procedure with the potential for longitudinal evaluation of both sensory and autonomic fibers. Unmyelinated small fibers are not otherwise quantified objectively with such a level of sensitivity as has been reported with IENFD. Recent advances include an expansion of the skin punch biopsy technique to evaluate larger myelinated fibers and mechanoreceptors, and recent work has also focused on additional methods of quantifying dermal fibers and densely innervated autonomic structures. This review discusses current work using skin biopsy for the pathologic analysis of peripheral nerve fibers in neuropathy of various causes as well as its use in clinical trials.
authors.affiliation: Department of Neurology, Vanderbilt University School of Medicine, A-0118 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232, USA.
authors.forename: M Iliza
authors.initials: MI
authors.lastname: Myers
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Peltier
mesh_terms: D001369:Axons / Q000378:metabolism / Q000473:pathology; D001706:Biopsy / Q000379:methods*; D006801:Humans; D016253:Microscopy, Immunoelectron; D004676:Myelin Basic Protein / Q000378:metabolism; D009412:Nerve Fibers / Q000473:pathology* / Q000648:ultrastructure; D009419:Nerve Tissue Proteins / Q000378:metabolism; D010523:Peripheral Nervous System Diseases / Q000145:classification / Q000175:diagnosis*; D012867:Skin / Q000294:innervation / Q000473:pathology*; D043222:Ubiquitin Thiolesterase / Q000378:metabolism
chemical_list: D004676:Myelin Basic Protein; D009419:Nerve Tissue Proteins; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase