Peripheral neuropathy for dermatologists: What if not diabetic neuropathy?

Tiffany Kwok, Patricia T. Ting, Eric K. Wong, Alain Brassard

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: Patients with cutaneous manifestations associated with peripheral neuropathy often present to the dermatologist's office. Objective/Methods: This article outlines a practical approach for obtaining the history, performing a screening physical examination, and ordering initial diagnostic testing to diagnose the cause of nondiabetic neuropathy. When to refer for neurologic consultation and principles of management of neuropathic pain and neuropathy-related ulcers are also discussed. Results: Cutaneous manifestations of peripheral neuropathy may be secondary to a medical condition predisposing the patient to neuropathy or a manifestation of neuropathy itself. In the latter category, skin affected by neuropathy may show characteristics of xerosis, anhidrosis, rubor, edema, callus, ulceration, muscle wasting, and foot deformity. Most often these findings occur in association with diabetic neuropathy; however, many other infectious, inflammatory, metabolic, paraneoplastic, hereditary, and medication- or toxin-related causes should be considered. The treatment of cutaneous manifestations of neuropathy includes pressure downloading, control of edema, and optimal ulcer and neuropathic pain management. Conclusion: It is important for dermatologists to have a basic approach to neuropathy in patients with related skin disease. Referral to Neurology is warranted when basic workup for reversible causes is negative or for any severe, rapidly progressive symptoms.

Original languageEnglish (US)
JournalJournal of Cutaneous Medicine and Surgery
Volume17
Issue numberSUPPL.1
DOIs
StatePublished - Jul 1 2013
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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