Founded in 1993 by Dr. Justin McArthur, the Johns Hopkins Medicine Cutaneous Nerve Laboratory was established to develop a better and simpler method of identifying small nerve fibers in the skin - a type of fiber frequently affected in some types of peripheral neuropathies.
A cutaneous nerve/skin biopsy is a simple, non-invasive procedure which is performed in the outpatient setting and takes approximately 10 to 15 minutes.
- First, the skin is thoroughly cleaned and a small injection of a local anesthetic to numb the skin is made.
- Then, a sample of skin is taken by a biopsy from the numb area of the skin.
- Finally, a band-aid dressing is used to cover the biopsy site.
Generally, the skin heals easily within one to two weeks. The risk of bleeding or infection is extremely low.
There are numerous benefits of the skin biopsy procedure. Skin biopsy can have immediate applications in assessing the overall health of sensory nerves on an outpatient basis and can therefore be offered as an additional diagnostic resource to clinicians. The immunohistochemical process allows for staining of single, unmesylinated nerves which are not only sensory but also autonomic. This allows an overall assessment of skin associated structures such as hair follicles, sweat glands, sebaceous glands, and arrector pili muscles.
Any area of the skin that has neuropathic symptoms can be biopsied and is therefore a candidate for analysis by immunohistochemistry. We have successfully used this technique to aid in the diagnosis and treatment of:
- Post herpetic neuralgia
- Restless leg syndrome (RLS)
- Toxic and idiopathic neuropathies
- HIV-associate and diabetic neuropathy
- Various forms of autonomic dysfunction