Biopsie cutanée et neuropathies des petites fibres

The diagnosis of small-fiber neuropathy is usually suspected in patients with distal neuropathic pain. Clinical examination is often near normal and nerve conduction studies usually do not display neuropathic changes. For several years, other clinical forms of small-fiber neuropathy have been described and new diagnostic tools have emerged. Alongside, the causes of small-fiber neuropathy are better known, and besides metabolic etiologies, dysimmune causes are discussed. Skin biopsy is a simple technique and has become a key tool in the diagnostic strategy of small-fiber neuropathy. We present here its technical aspects as well as its diagnostic yield in the context of suspected small-fiber neuropathy, and its potential developments.