What is the role of skin biopsy for evaluating small fiber neuropathy in patients with rheumatic disease who have treatment recalcitrant pain?

I have a shared decision-making discussion with the patient, especially alluding to the fact that the result would not change my therapy (i.e., use neuropathic analgesics for treatment) for small fiber neuropathy (SFN).

Where I find it especially useful is in a patient with systemic lupus (SLE) or S...

This is a great topic for discussion, and I want to thank all experts who made very valuable comments.

As a Neurologist, I tend to side more towards Dr. @Dr. First Last’s opinion. What I would encourage everybody to read is a review article by 3 international experts in SFN (Drs. Lauria, Faber and Co...

There are a lot of aspects to this question. But they all fall under the umbrella of: "What will the biopsy tell me that will change treatment decisions or change diagnostic thinking?"

I rarely order skin biopsy for IENFD as the symptoms are usually pain, and the treatment for this pain will not be i...

I greatly appreciate the thoughtful perspectives shared by Drs. @Dr. First Last and @Dr. First Last on the nuances of interpreting skin biopsy results. While I agree that small fiber neuropathy (SFN) is ultimately a clinical diagnosis that should not rest solely on a single abnormal ENFD number, I b...