EMLA-Induced Skin Wrinkling for the Detection of Diabetic Neuropathy.

摘要: Objective To determine the usefulness of Eutectic Mixture Local Anesthetic (EMLA)-induced stimulated skin wrinkling (SSW) to detect diabetic sensorimotor polyneuropathy (DSPN). Research Design and Methods 210 diabetics were prospectively recruited (mean age 58.5±12.7 years) from a large tertiary center 2009 2011. EMLA was applied tips digits 2, 3 4 degree graded. Diabetic Neuropathy Symptom (DNS) score, nerve conduction studies (NCS), Semmes-Weinstein monofilament (SWMF) tests, vibratory perception thresholds (VPT) testing chosen as comparative clinical standards diagnose length-dependent DSPN. Results Inter-rater agreement for 2 examiners SSW high, with Cohen’s weighted Κ 0.912 right hand, 0.823 left. K measure NCS, DNS scores, SWMF VPT 0.486, 0.243, 0.289 0.395 respectively. able distinguish between normal abnormal NCS results, median scores 3.333 vs 1.667 (p<0.0005); 3.167 2.000 (p<0.0005) Following ROC analysis, at cut-off point < an test, sensitivity test diagnosing DSPN using reference standard 81.3%, specificity 67.0%, on par other methods. Conclusions Stimulated shows comparable methods detecting Given its low cost easy administration, can be considered useful alternative screening method neuropathy.