The neuropathic process typically progresses in a distal to proximal fashion, or in other words, in a “stocking and glove” type distribution. SFPN may present with varying symptoms, however, most commonly presents with burning/shooting pains, pins and needle sensation or numbness and coldness over the extremity. ENFD analysis may also reveal degenerative changes in those patients with normal densities, which may predict the future onset of SFPN. The analysis not only provides definitive confirmation of SFPN, but also enables better assessment of the severity of the neuropathic process, which may have treatment implications. īakoDx’s epidermal nerve fiber density (ENFD) analysis is an objective diagnostic tool used to monitor and manage patients with small fiber peripheral neuropathy (SFPN). A complimentary copy is available to all podiatrists at. This is helpful in identifying the best practices for specimen collection. Bako Diagnostics has published the “Lower Extremity Biopsy Techniques,” a Practice Essentials guide for the podiatric medical professional. Understanding the appropriate scenarios to use the varying specimen collection techniques (punch, shave, scraping, excision, avulsion, etc.), the correct preservatives to use, and how to avoid sampling artifact – are all key to proper submission and diagnosis. Upload capabilities are available for podiatrists through the Bako Diagnostics web portal. In addition, uploading images of your patient’s lesion can be valuable to diagnosis and treatment suggestions. When submitting a specimen, be sure the basic requisition forms are complete and add as much specific information as possible – biopsy site, lesion location/description/history, clinical differential diagnosis.
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