Skin biopsy for peripheral neuropathy
Is it better to punch or to blister?
Citation Manager Formats
Make Comment
See Comments

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Estimates of intraepidermal nerve fiber densities (IENFDs) obtained from 3 mm punch biopsies of skin have emerged as a method to diagnose small fiber sensory polyneuropathy, e.g., chronic idiopathic axonal polyneuropathy. The technique is reported to be diagnostically useful, especially in patients with normal nerve conduction studies. However, earlier investigations of Meissner corpuscles found variable densities of contiguous biopsy sites, especially in older persons, a limitation of the technique for diagnostic purposes.1
With visualization of unmyelinated nerve fibers using immunoreactivity to protein gene product 9.5 protein, it became possible to count these fibers in skin punch biopsy specimens. There are reports on its validity, tolerability, and reliability.2-5 An alternative to punch biopsy is skin blister biopsy using suction, the latter separating epidermis from dermis.6 William R. Kennedy, who with colleagues developed the blister technique, gives two reasons for preferring blister to punch: 1) less scarring and 2) possibility of sampling a larger area (W.R. Kennedy, University of Minnesota, personal communication, 2008).
In this issue of Neurology®, Panoutsopoulou et …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study
Dr. Robert Shapiro and Dr. Amynah Pradhan
Related Articles
- No related articles found.