title: Epidermal innervation in healthy children and adolescents.
abstract: BACKGROUND
  Epidermal nerve fiber (ENF) density, morphology, and epidermal innervation patterns were examined in children using 2 different techniques, punch biopsy and suction blister.
  
  
  METHODS
  Healthy children without symptoms or history of peripheral neuropathy and normal by neurologic examination were studied. Punch biopsy and suction blister specimens were collected from the lateral thigh and distal leg. ENFs were traced from confocal images of immunohistochemically stained samples. Statistical methods included repeated-measures analysis of covariance.
  
  
  RESULTS
  Blister and biopsy nerve counts were associated. ENF density in children was dense, lower for older children (P<0.01) and with no difference between boys and girls (P=0.92). Many ENFs appeared multibranched and elongated.
  
  
  CONCLUSIONS
  Epidermal innervation in the pediatric population is dense and age-dependent. Blister specimens are less invasive and may provide an alternative to punch biopsy for determining ENF density in children at risk for neuropathy.
authors.affiliation: Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Ioanna G
authors.initials: IG
authors.lastname: Panoutsopoulou
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Luciano
authors.forename: Gwen
authors.initials: G
authors.lastname: Wendelschafer-Crabb
authors.forename: James S
authors.initials: JS
authors.lastname: Hodges
authors.forename: William R
authors.initials: WR
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D004817:Epidermis / Q000737:chemistry* / Q000294:innervation*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D009412:Nerve Fibers / Q000737:chemistry*
keywords: children; epidermal nerve fibers; immunohistochemistry; peripheral neuropathy; skin biopsy