Fouchard Maxime, Brenaut Emilie, Genestet Steeve, Ficheux Anne-Sophie, Marcorelles Pascale, Misery Laurent
Department of Dermatology, CHU Brest, Brest, France.
Univ Brest, LIEN, Brest, France.
Front Med (Lausanne). 2023 Jan 12;9:1051967. doi: 10.3389/fmed.2022.1051967. eCollection 2022.
Small fiber neuropathies (SFNs) are disorders of skin nerve endings inducing pruritus, burning pain, numbness, and paresthesia. The aims of this study were to search for putative etiologies of SFN and their occurrence in a cohort of patients and to compare patients with SFN to a group of patients without SFN to highlight potential factors associated with SFN.
This study was observational, retrospective, and monocentric. All patients with symptoms of SFN who underwent skin biopsies with intraepidermal nerve density counts were included. Patients with a count lower than 5 percentiles were considered to be in the SFN group. Other patients were considered to be the control group.
A total of 162 patients with SFN and 161 controls were included. No cause was identified for 108 patients (61.7%). The established causes were autoimmune diseases (9.1%), diabetes or glucose intolerance (8%), medication (4%), liver disease (3.4%), and monoclonal gammopathy of undetermined significance (2.9%). Current or former smokers were more numerous in the SFN group (26.5%) than in the control group (16.1%), while vitamin D amounts were significantly lower in the SFN group than in the control group.
Hence, tobacco smoking and vitamin D deficiency might be new putative causes of SFN.
小纤维神经病变（SFN）是一种皮肤神经末梢疾病，可引发瘙痒、灼痛、麻木和感觉异常。本研究的目的是寻找SFN的潜在病因及其在一组患者中的发生率，并将SFN患者与一组无SFN的患者进行比较，以突出与SFN相关的潜在因素。
本研究为观察性、回顾性和单中心研究。纳入所有有SFN症状且接受了表皮内神经密度计数的皮肤活检的患者。计数低于第5百分位数的患者被认为属于SFN组。其他患者被认为是对照组。
共纳入162例SFN患者和161例对照。108例患者（61.7%）未查明病因。已确定的病因包括自身免疫性疾病（9.1%）、糖尿病或糖耐量异常（8%）、药物（4%）、肝脏疾病（3.4%）以及意义未明的单克隆丙种球蛋白病（2.9%）。SFN组中当前或既往吸烟者（26.5%）比对照组（16.1%）更多，而SFN组的维生素D水平显著低于对照组。
因此，吸烟和维生素D缺乏可能是SFN新的潜在病因。
