Cutaneous Nerve Lab | Johns Hopkins Neurology and Neurosurgery

Founded in 1993 by Justin McArthur, M.B.B.S., M.P.H. and the late Jack Griffin, Johns Hopkins Cutaneous Nerve Laboratory was established to develop a better and simpler method of identifying small nerve fibers in the skin that are frequently affected in some types of peripheral neuropathies.

The Cutaneous Nerve Laboratory was the first Clinical Laboratory Improvement Amendments (CLIA) certified laboratory to use epidermal nerve fiber analysis as a diagnostic tool, and ever since has been at the forefront of assessing the diagnostic and prognostic value of skin biopsies in neurological disease.

Our Services

We offer cutaneous nerve biopsies to all physicians, with diagnostic services to identify and monitor small fiber neuropathies through minimally invasive 3mm skin punch specimens, which we analyze for epidermal nerve fiber density and morphological changes. Our services include:

Biopsy kits with tools and return shipping
Assessment of intraepidermal nerve fiber density
Evaluation of sweat gland innervation

Staining to screen for the presence of amyloid
Pathological review of all specimens by neuromuscular trained specialists

Flexibility and Convenience for Patients and Physicians

Patients and physicians can choose to perform the biopsy in their office or at Johns Hopkins. For more information or to schedule a skin punch biopsy at Johns Hopkins, please call 410-614-6399.

At Johns Hopkins

Patients can have the biopsy performed at the Johns Hopkins Outpatient Center or the Johns Hopkins Bayview Medical Center. View biopsy information for patients.
Outside of Johns Hopkins

Physicians can perform the biopsy at their offices and mail the tissue sample to our laboratory using our biopsy kit. Learn about the process.

What a Skin/Nerve Biopsy Can Tell Us

Looking under the microscope at a small sample of skin taken from an arm or leg can show the number of sensory nerves present — the nerves that enable the feeling of touch, heat and cold, and pain. The test can also reveal the shape and general health of these nerves, including:

Show abnormal epidermal nerve fiber innervation
Detect the severity of neuropathy at sites not easily tested through electrophysiology
Reveal abnormal nerve fiber morphology associated with development of neuropathy
Provide a pathological alternative in settings where electrophysiology is not available
Distinguish neuropathy from other causes of pain
Diagnose presence of amyloid