Characterization of dermal skin innervation in fibromyalgia syndrome 2020


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Characterization of dermal skin innervation in fibromyalgia syndrome
  • Dimitar Evdokimov,
  • Philine Dinkel,
  • Johanna Frank,
  • Claudia Sommer,
  • Nurcan Üçeyler
Published: January 13, 2020


We characterized dermal innervation in patients with fibromyalgia syndrome (FMS) as potential contribution to small fiber pathology.

Skin biopsies of the calf were collected (86 FMS patients, 35 healthy controls). Skin was immunoreacted with antibodies against protein gene product 9.5, calcitonine gene-related peptide, substance P, CD31, and neurofilament 200 for small fiber subtypes. We assessed two skin sections per patient; on each skin section, two dermal areas (150 x 700 μm each) were investigated for dermal nerve fiber length (DNFL).

In FMS patients we found reduced DNFL of fibers with vessel contact compared to healthy controls (p<0.05). There were no differences for the other nerve fiber subtypes.

We found less dermal nerve fibers in contact with blood vessels in FMS patients than in controls. The pathophysiological relevance of this finding is unclear, but we suggest the possibility of a relationship with impaired thermal tolerance commonly reported by FMS patients.


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U.S., Earth
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