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Gender Differences in Skin Biopsy Findings in Small Fiber Neuropathy

A Retrospective Chart Review

Weaver, Joshua, MD; Kim, Kyung-Wha, MD; Carey, Bridget T., MD; Langsdorf, Jennifer A., MD; Chin, Russell L., MD

Journal of Clinical Neuromuscular Disease: December 2018 - Volume 20 - Issue 2 - p 69–75
doi: 10.1097/CND.0000000000000228
Original Article

Objectives: To determine whether there are gender differences in the clinical presentation or skin biopsy measures of nerve fiber density in patients with small fiber neuropathy (SFN).

Methods: Retrospective chart review of subjects with suspected SFN.

Results: Of 218 cases (137 women and 81 men) with suspected SFN, 96 (44%), including 63% of the men and 33% of the women (P < 0.05), had low epidermal nerve fiber density (ENFD) or sweat gland nerve fiber density (SGNFD). There were no differences in the clinical presentation between men and women. In those with abnormal findings, low ENFD alone was more frequent in women than men (51.1% vs. 7.8%, P < 0.05), whereas abnormal SGNFD alone was more frequent in men than women (68.6% vs. 11.1%, P < 0.05). Both SGNFD and ENFD were low in 23.5% of men and 33.3% of women. Skin biopsy findings were independent of clinical presentation or etiology.

Conclusions: The clinical presentation of SFN is similar in men and women. In skin biopsy studies, low ENFD is more common in women and low SGNFD in men.

Department of Neurology, Weill Cornell Medical College, New York, NY.

Reprints: Joshua Weaver, MD, Department of Neurology, Weill Cornell Medical College, 156 William St, 11th Floor, New York, NY 10038 (e-mail:

The authors report no conflicts of interest.

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