Skin biopsy for diagnosis of small fiber neuropathy: a critically appraised topic.

Background: Patients with lower extremity sensory symptoms and pain but without clinical or standard neurophysiological examination abnormalities may have a small fiber neuropathy. Skin biopsy with intraepidermal nerve fiber density (IENFD) assessment has been promoted as a diagnostic tool for such patients.

Objectives: To evaluate the diagnostic utility of skin biopsy with IENFD in patients with suspected small fiber neuropathy.