Intraepidermal Nerve Fiber Density: Diagnostic and Therapeutic Relevance in the Management of Chronic Pruritus: a Review.

摘要: In recent years, measurement of the intraepidermal nerve fiber (IENF) density has gained relevance in diagnostics chronic pruritus. This method allows objectification and quantification a small-fiber neuropathy, which may manifest clinically with pruritus, pain or dysesthetic sensory symptoms, such as burning, stinging tingling sensations numbness. Upon suspicion neuropathy cause for targeted diagnostic procedures are essential early detection neuroanatomical changes. After punch biopsy lower leg, obtained tissue undergoes an immunofluorescence staining process primary antibody against protein gene product 9.5. The IENFs can thus be detected quantified according to pre-determined guidelines based on international consensus. addition morphological changes, functional impairment small-fibers assessed using quantitative testing by assessing thresholds various thermal mechanic modalities. method, however, is time-consuming requires specialized investigator, it not routinely used investigation Diagnosing underlying pruritus therapeutic relevance. If possible, should treated. Alternatively, symptomatic therapy options include topical (capsaicin) systemic (anticonvulsants and/or antidepressants) agents. Chronification processes lead refractory treatment initiated soon possible. aim this review present discuss IENF tool its role management patients A brief case report presented better illustrate clinical setting.