Additional skin biopsy could widen the diagnostic window of vasculitic neuropathy

Abstract

A substantial percentage of vasculitic neuropathy patients remain undiagnosed, even after combined nerve/muscle biopsy. In Masuda's article in this issue of the journal, the addition of a simultaneous skin biopsy yielded a mere 12% increase in the diagnostic accuracy; however, this procedure is worth considering because of its non-invasive nature, and future detailed morphological analyses of biopsied skin specimens might further widen the diagnostic window of vasculitic neuropathy.The proper diagnosis of vasculitic neuropathy is challenging, and the morphological confirmation of the vasculitic pathology is mandatory. A negative biopsy does not exclude the diagnosis of vasculitic neuropathy, because the pathological changes of necrotizing neuropathy are present segmentally; not uniformly existing along the whole length of the peripheral nervous system.