SMALL-FIBER NEUROPATHIES

Clinical

In one study [JAAD 2015;72;328-32], sensory complaints included (in decreasing frequency): burning (77%), pain (72%), heat sensation (70%), pruritus (68%), numbness (68%), crawling (65%), stinging (60%), electric discharge (59%), and cold sensation (58%). Itching is most common on the extremities and is most severe in the evening.

Abnormal sweating is a finding in, component of, and marker for neuropathies, especially small-fibre neuropathy. In one study [British Journal of Dermatology, 172: 412–418], thermoregulatory sweat testing was abnormal in the majority of patients with itching, burning, numbness, and tingling sensations involving the skin, and the areas of anhidrosis on TST corresponded to their symptomatic areas.

Treatment

Gabapentin and pregabalin are used.


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