Epidermal Nerve Fiber Density Test – Biopsy Sites
Standard Biopsy sites for ENFD Testing
Therapath has established five standard biopsy sites for Epidermal Nerve Fiber Density (ENFD) and Sweat Gland Nerve Fiber Density (SGNFD). These sites allow for the diagnosis of a Small Fiber Neuropathy affecting either the upper or lower extremities in patients 18 and older.
The standard sites include the Proximal Arm, Distal Arm, Thigh, Distal Leg, and Foot. More details are available on our biopsy procedure guide.
The Epidermal Nerve Fiber Density (ENFD) test measures the density of the small sensory nerve fibers in the skin, and the Sweat Gland Nerve Fiber Density (SGNFD) test measures the density of the small autonomic nerve fibers in the sweat glands.1,2 The same biopsy sample can be used for both tests.
The skin biopsy procedure can be performed at the physician’s office and is reimbursed using CPT codes 11100 and 11101.

- Joint T. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. J Peripher Nerv Syst. 2010;15(2):79-92. [PubMed]
- Gibbons C, Illigens B, Wang N, Freeman R. Quantification of sweat gland innervation: a clinical-pathologic correlation. Neurology. 2009;72(17):1479-1486. [PubMed]
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Epidermal Nerve Fiber Density Test – Biopsy Sites
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Therapath has established five standard biopsy sites for Epidermal Nerve Fiber Density (ENFD) and Sweat Gland Nerve Fiber Density (SGNFD). [Read More]
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Epidermal Nerve Fiber Density Test – Biopsy Sites
Standard Biopsy sites for ENFD Testing
Therapath has established five standard biopsy sites for Epidermal Nerve Fiber Density (ENFD) and Sweat Gland Nerve Fiber Density (SGNFD). These sites allow for the diagnosis of a Small Fiber Neuropathy affecting either the upper or lower extremities in patients 18 and older.
The standard sites include the Proximal Arm, Distal Arm, Thigh, Distal Leg, and Foot. More details are available on our biopsy procedure guide.
The Epidermal Nerve Fiber Density (ENFD) test measures the density of the small sensory nerve fibers in the skin, and the Sweat Gland Nerve Fiber Density (SGNFD) test measures the density of the small autonomic nerve fibers in the sweat glands.1,2 The same biopsy sample can be used for both tests.
The skin biopsy procedure can be performed at the physician’s office and is reimbursed using CPT codes 11100 and 11101.

- Joint T. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. J Peripher Nerv Syst. 2010;15(2):79-92. [PubMed]
- Gibbons C, Illigens B, Wang N, Freeman R. Quantification of sweat gland innervation: a clinical-pathologic correlation. Neurology. 2009;72(17):1479-1486. [PubMed]
Related Articles
Epidermal Nerve Fiber Density Test – Biopsy Sites
therapath2022-09-05T19:02:43-05:00
Therapath has established five standard biopsy sites for Epidermal Nerve Fiber Density (ENFD) and Sweat Gland Nerve Fiber Density (SGNFD). [Read More]
Abstract: Associated Conditions in Small Fiber Neuropathy
therapath2022-09-05T19:01:46-05:00
De Greef et al. studied 921 patients with confirmed small fiber neuropathy in order to investigate the prevalence of associated conditions in SFN patients. [Read More]
Abstract: Idiopathic Small Fiber Neuropathy in Children
therapath2022-09-05T17:30:24-05:00
Balushi, Kim, Krause, and Kafie looked at idiopathic small fiber neuropathy findings in children who had small fiber neuropathy confirmed by history, clinical exam, and low intraepidermal nerve fiber density. [Read More]
Abstract: Prediabetes and Small Fiber Neuropathy
therapath2022-09-05T17:45:25-05:00
Thaisetthawatkul, Fernandes, and Herrmann looked at the connection between prediabetes and small fiber neuropathy. [Read More]