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Cutaneous Nerve Laboratory

The Johns Hopkins Cutaneous Nerve Laboratory was established in 1993 and was the first CLIA certified laboratory to use epidermal nerve fiber analysis as a diagnostic tool. The laboratory has been at the forefront of assessing the diagnostic and prognostic value of skin biopsies in neurological disease. We now offer these tests as a clinical service to all physicians.


The lab provides diagnostic services to identify and monitor small fiber neuropathies through skin samples. Minimally-invasive 3mm skin punch specimens are analyzed for epidermal nerve fiber density and morphological changes.

What can skin biopsies detect?

  • Abnormal epidermal nerve fiber innervation
  • Severity of neuropathy at sites not easily tested through electrophysiology
  • Abnormal nerve fiber morphology which can predict development of neuropathy
  • A pathological alternative in settings where electrophysiology is not available
  • Distinguish neuropathy from other causes of pain

Our laboratory offers:

  • Assessment of intraepidermal nerve fiber density
  • Evaluation of sweat gland innervation
  • Pathological review of all specimen by neuromuscular trained specialists
  • Rapid turnaround of results, typically less than 7 days from the time the sample is received
  • Biopsy kits with tools and return shipping

Our comprehensive diagnostic services are offered to both practicing physicians and patients.

Biopsies can be performed at physicians offices and then sent to the cutaneous nerve lab, or at the Johns Hopkins Outpatient Center or the Johns Hopkins Bayview Medical Center. In both situations, our staff will secure the patient's insurance authorization once the appropriate referral forms have been completed. If a physician wants to perform the biopsy at his or her office, a biopsy kit can be mailed once the patient's insurance authorization is obtained.

Contact us

For more information, please contact us at: 410-614-6399. You can also schedule skin punch biopsies at Johns Hopkins.


How Can We Help You?

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