Correlations between peripheral neuropathy profiles and vascular skin lesions

Area of Science:

• Neurology
• Dermatology
• Vascular Medicine

Background:

• Peripheral neuropathies can manifest as severe, life-threatening vascular skin lesions.
• These neurocutaneous associations include livedo racemosa, ulcers, palpable purpura, and necrosis.

Purpose of the Study:

• To investigate phenotypic correlations between neuropathy profiles and specific vascular skin lesion subtypes.
• To explore shared underlying mechanisms in these neurocutaneous syndromes.

Main Methods:

• A retrospective monocentric study analyzed data from 41 patients with peripheral neuropathy and vascular skin lesions.
• Data included clinical, electrophysiological, and histopathological findings from 1993-2022.

Main Results:

• Mononeuritis multiplex (MM) correlated with purpura and livedo, often linked to vasculitis or vaso-occlusion.
• Polyneuropathy (PNP) was associated with plantar ulcers, frequently stemming from diabetes or chronic renal failure.
• The onset of skin lesions relative to neuropathy differed significantly between MM (median 1 month) and PNP (median 58 months).

Conclusions:

• Skin lesion type can indicate neuropathy phenotype and underlying etiology.
• Livedo, purpura, and supraplantar ulcers suggest MM due to ischemia.
• Plantar ulcers point towards chronic PNP affecting large and small fibers.