Investigation of nerve fibers in the skin by biopsy: technical aspects, indications, and contribution to diagnosis of small-fiber neuropathy

ABSTRACT Skin biopsy with investigation of small-diameter nerve fibers in human epidermis and dermis has been proven to be a useful method for confirming small-fiber neuropathy. In medical practice, small-fiber neuropathy is increasingly recognized as a leading cause of neuropathic pain. It is a prevalent complaint in medical offices, brought by patients often as a “painful burning sensation”. The prevalence of neuropathic pain is high in small-fiber neuropathies of different etiologies, especially in the elderly; 7% of population in this age group present peripheral neuropathy. Pain and paresthesia are symptoms which might cause disability and impair quality of life of patients. The early detection of small-fiber neuropathy can contribute to reducing unhealthy lifestyles, associated to higher incidence of the disease.

摘要 对人类表皮（epidermis）与真皮（dermis）内的小直径神经纤维（small-diameter nerve fibers）进行检测的皮肤活检（skin biopsy），已被证实为确诊小纤维神经病（small-fiber neuropathy）的有效手段。在临床实践中，小纤维神经病正日益被认定为神经性疼痛（neuropathic pain）的主要诱因。此类病症在门诊中十分常见，患者常以“烧灼样疼痛”为主诉就诊。不同病因所致的小纤维神经病患者中，神经性疼痛的患病率居高不下，尤以老年群体为甚；该年龄段人群中有7%罹患周围神经病（peripheral neuropathy）。疼痛与感觉异常（paresthesia）是可能导致患者失能、降低其生活质量的症状。早期检出小纤维神经病，有助于减少与该病高发病率相关的不健康生活方式。