In this issue of Scandinavian Journal of Pain Páll Karlsson and co-workers publish a study of the sensitivity and specificity of various methods for the diagnosis of small fibre impairment in patients with painful distal sensory polyneuropathies compared with healthy subjects . In more detail, they have compared results of quantitative sensory testing (QST) (including temperature thresholds), response on pain and local vasodilatation by topical application of capsaicin, and various morphological variables of skin biopsies, such as intraepidermal nerve fibre density (IENFD) and new measures such as small fibre axonal swellings and the epidermal and dermal nerve length density (eNFLD and dNFDL).1Improving diagnostic accuracy of painful distal sensory polyneuropathiesThe authors address in this report a very important question: how to improve the diagnostic accuracy of painful distal sensory polyneuropathy (DSP). Painful DSP is worldwide a large problem, affecting many millions of patients. Diabetes mellitus is the most common cause of neuropathy  and with a considerable world-wide increase in diabetes, the occurrence of diabetic neuropathy is increasing [2,3]. In addition, other diseases like hypothyroidism , HIV , connective tissue diseases , and a large variety of inherited diseases may be complicated by or manifested by a painful neuropathy .
Scandinavian Journal of Pain – de Gruyter
Published: Jan 1, 2016
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