title: Peripheral neuropathy for dermatologists: what if not diabetic neuropathy?
abstract: BACKGROUND
  Patients with cutaneous manifestations associated with peripheral neuropathy often present to the dermatologist's office.
  
  
  OBJECTIVE
  This article outlines a practical approach for obtaining the history, performing a screening physical examination, and ordering initial diagnostic testing to diagnose the cause of nondiabetic neuropathy. When to refer for neurologic consultation and principles of management of neuropathic pain and neuropathy-related ulcers are also discussed.
  
  
  RESULTS
  Cutaneous manifestations of peripheral neuropathy may be secondary to a medical condition predisposing the patient to neuropathy or a manifestation of neuropathy itself. In the latter category, skin affected by neuropathy may show characteristics of xerosis, anhidrosis, rubor, edema, callus, ulceration, muscle wasting, and foot deformity. Most often these findings occur in association with diabetic neuropathy; however, many other infectious, inflammatory, metabolic, paraneoplastic, hereditary, and medication- or toxin-related causes should be considered. The treatment of cutaneous manifestations of neuropathy includes pressure downloading, control of edema, and optimal ulcer and neuropathic pain management.
  
  
  CONCLUSIONS
  It is important for dermatologists to have a basic approach to neuropathy in patients with related skin disease. Referral to Neurology is warranted when basic workup for reversible causes is negative or for any severe, rapidly progressive symptoms.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Kwok
authors.forename: Patricia T
authors.initials: PT
authors.lastname: Ting
authors.forename: Eric K
authors.initials: EK
authors.lastname: Wong
authors.forename: Alain
authors.initials: A
authors.lastname: Brassard
mesh_terms: D003880:Dermatology / Q000379:methods*; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis*