Skin biopsy in assessing meralgia paresthetica

Area of Science:

• Neurology
• Dermatology
• Pathology

Background:

• Meralgia paresthetica is a focal neuropathy resulting from lateral femoral cutaneous nerve (LFCN) compression.
• Diagnosing meralgia paresthetica can be challenging using conventional neurophysiological or imaging techniques.

Purpose of the Study:

• To investigate the utility of intraepidermal nerve fiber density (IENFD) assessment via skin biopsy in diagnosing meralgia paresthetica.

Main Methods:

• A retrospective study of 5 patients with suspected meralgia paresthetica was conducted.
• Skin biopsies were performed to evaluate intraepidermal nerve fiber density (IENFD) in affected and unaffected areas.

Main Results:

• All 5 patients exhibited reduced IENFD in the symptomatic thigh.
• Two patients also showed reduced IENFD in the asymptomatic thigh, while 4 had normal IENFD in the distal leg.
• Common contributing factors included obesity, tight clothing, and diabetes mellitus.

Conclusions:

• Meralgia paresthetica is associated with a loss of small intraepidermal nerve fibers.
• Skin biopsy and IENFD evaluation represent a potentially valuable diagnostic method for meralgia paresthetica.