Pruritis and Small Fiber Neuropathy
Chronic pruritis (itching sensation) is associated with a number of medical conditions including several neuropathic illnesses.1 Among those illnesses, small fiber neuropathy (SFN) can cause neuropathic itching. Patients with SFN commonly report pruritis as a leading symptom.2
Pereira et al. report on the diagnostic value of Epidermal Nerve Fiber Density (ENFD) in the management of chronic pruritis. The authors discuss the importance of investigating the underlying cause of the condition:
“An early diagnosis of a neuropathy as the underlying cause of pruritus is essential for the treatment success. Current guidelines recommend the treatment of the underlying cause or, if not possible, the application of topical capsaicin or the systemic use of anticonvulsants or antidepressants.” 3
Other causes of neuropathic pruritis include nerve lesions, radiculopathy, spinal cord damage, and brain lesions.4 Due to the wide range of conditions associated with neuropathic pruritis, ENFD can be a valuable tool in patient evaluation.
Chronic pruritis can lead to skin changes and injuries from scratching. This self injury can be exacerbated in patients with neuropathic sensory loss that allows for scratching without pain.
- Twycross R, Greaves M, Handwerker H, et al. Itch: scratching more than the surface. QJM. 2003;96(1):7-26. [PubMed]
- Brenaut E, Marcorelles P, Genestet S, Ménard D, Misery L. Pruritus: an underrecognized symptom of small-fiber neuropathies. J Am Acad Dermatol. 2015;72(2):328-332. [PubMed]
- Pereira M, Mühl S, Pogatzki-Zahn E, Agelopoulos K, Ständer S. Intraepidermal Nerve Fiber Density: Diagnostic and Therapeutic Relevance in the Management of Chronic Pruritus: a Review. Dermatol Ther (Heidelb). 2016;6(4):509-517. [PMC]
- Oaklander A. Neuropathic Itch. Semin Cutan Med Surg. 2011;30(2):87-92. [PMC]
Related Articles
Research Finds Nerve Damage in Patients with Fibromyalgia
Becky Tsai2022-09-05T17:50:29-05:00
Therapath, LLC reports that new findings have revealed that patients diagnosed with fibromyalgia may also have a diagnosable small fiber neuropathy. [Read More]
Quality of Life and Usefulness of Skin Biopsy in Small Fiber Neuropathy (SFN)
Becky Tsai2022-09-05T17:51:25-05:00
Bakkers et al examined a total of 265 patients diagnosed with small fiber neuropathy (SFN). They found that SFN was associated with a severe impairment in Quality of Life...[Read More]
New Upper Extremity Standard Biopsy Sites for Diagnosis of Small Fiber Neuropathy
Becky Tsai2022-09-05T17:52:41-05:00
Therapath LLC has established normative values for two upper limb body sites that can now be used to evaluate 3mm punch skin biopsy specimens...[Read More]
United Healthcare Signs Therapath Neuropathology to National Agreement to Provide Specialty Neuropathology Services to United Healthcare Members
Becky Tsai2022-09-05T17:54:35-05:00
Therapath LLC, the leader in comprehensive diagnostic and consultative neuropathology laboratory services, has signed a national contract with United Healthcare...[Read More]
Pruritis and Small Fiber Neuropathy
Chronic pruritis (itching sensation) is associated with a number of medical conditions including several neuropathic illnesses.1 Among those illnesses, small fiber neuropathy (SFN) can cause neuropathic itching. Patients with SFN commonly report pruritis as a leading symptom.2
Pereira et al. report on the diagnostic value of Epidermal Nerve Fiber Density (ENFD) in the management of chronic pruritis. The authors discuss the importance of investigating the underlying cause of the condition:
“An early diagnosis of a neuropathy as the underlying cause of pruritus is essential for the treatment success. Current guidelines recommend the treatment of the underlying cause or, if not possible, the application of topical capsaicin or the systemic use of anticonvulsants or antidepressants.” 3
Other causes of neuropathic pruritis include nerve lesions, radiculopathy, spinal cord damage, and brain lesions.4 Due to the wide range of conditions associated with neuropathic pruritis, ENFD can be a valuable tool in patient evaluation.
Chronic pruritis can lead to skin changes and injuries from scratching. This self injury can be exacerbated in patients with neuropathic sensory loss that allows for scratching without pain.
- Twycross R, Greaves M, Handwerker H, et al. Itch: scratching more than the surface. QJM. 2003;96(1):7-26. [PubMed]
- Brenaut E, Marcorelles P, Genestet S, Ménard D, Misery L. Pruritus: an underrecognized symptom of small-fiber neuropathies. J Am Acad Dermatol. 2015;72(2):328-332. [PubMed]
- Pereira M, Mühl S, Pogatzki-Zahn E, Agelopoulos K, Ständer S. Intraepidermal Nerve Fiber Density: Diagnostic and Therapeutic Relevance in the Management of Chronic Pruritus: a Review. Dermatol Ther (Heidelb). 2016;6(4):509-517. [PMC]
- Oaklander A. Neuropathic Itch. Semin Cutan Med Surg. 2011;30(2):87-92. [PMC]
Related Articles
Research Finds Nerve Damage in Patients with Fibromyalgia
Becky Tsai2022-09-05T17:50:29-05:00
Therapath, LLC reports that new findings have revealed that patients diagnosed with fibromyalgia may also have a diagnosable small fiber neuropathy. [Read More]
Quality of Life and Usefulness of Skin Biopsy in Small Fiber Neuropathy (SFN)
Becky Tsai2022-09-05T17:51:25-05:00
Bakkers et al examined a total of 265 patients diagnosed with small fiber neuropathy (SFN). They found that SFN was associated with a severe impairment in Quality of Life...[Read More]
New Upper Extremity Standard Biopsy Sites for Diagnosis of Small Fiber Neuropathy
Becky Tsai2022-09-05T17:52:41-05:00
Therapath LLC has established normative values for two upper limb body sites that can now be used to evaluate 3mm punch skin biopsy specimens...[Read More]
United Healthcare Signs Therapath Neuropathology to National Agreement to Provide Specialty Neuropathology Services to United Healthcare Members
Becky Tsai2022-09-05T17:54:35-05:00
Therapath LLC, the leader in comprehensive diagnostic and consultative neuropathology laboratory services, has signed a national contract with United Healthcare...[Read More]
