title: Utility of skin biopsy in management of small fiber neuropathy.
abstract: BACKGROUND
  We examined the role of skin biopsy in the evaluation and management of patients with suspected small fiber neuropathy (SFN).
  
  
  METHODS
  A retrospective chart review was performed among all patients who underwent skin biopsy for evaluation of SFN at our institution between March 2008 and March 2011. Change in management was defined as a new diagnosis or change in treatment in response to both positive and negative skin biopsies.
  
  
  RESULTS
  Among 69 patients who underwent skin biopsy, 25 had pathological evidence of an SFN, and 9 had evidence of borderline SFN. Change in management or diagnosis occurred in 14 of 25 patients with definite SFN, 6 of 9 patients with borderline SFN, and 16 of 35 biopsy negative patients.
  
  
  CONCLUSIONS
  Skin biopsy changed management or diagnosis in 52% of patients evaluated for a possible SFN and appears to play a valuable role in the workup of these patients.
authors.affiliation: Autonomic and Peripheral Nerve Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, Massachusetts, 02215, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Boruchow
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Gibbons
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001706:Biopsy / Q000379:methods*; D004916:Erythromelalgia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012867:Skin / Q000473:pathology*; D055815:Young Adult
keywords: management; nerve fiber density; neuropathy; skin biopsy; small-fiber neuropathy