Founded in 1993 by Justin McArthur, M.B.B.S., M.P.H. and the late Jack Griffin, Johns Hopkins’ Cutaneous Nerve Laboratory was established to develop a better and simpler method of identifying small nerve fibers in the skin that are frequently affected in some types of peripheral neuropathies. The Cutaneous Nerve Laboratory was the first Clinical Laboratory Improvement Amendments (CLIA) certified laboratory to use epidermal nerve fiber analysis as a diagnostic tool, and ever since has been at the forefront of assessing the diagnostic and prognostic value of skin biopsies in neurological disease. We offer these tests to all physicians, with diagnostic services to identify and monitor small fiber neuropathies through minimally invasive 3mm skin punch specimens, which we analyze for epidermal nerve fiber density and morphological changes. *Why choose Johns Hopkins for cutaneous nerve biopsy analysis?* - Rapid turnaround of results, typically less than 7 days from receipt of sample - Biopsy kits with tools and return shipping - Assessment of intraepidermal nerve fiber density - Evaluation of sweat gland innervation - Congo Red staining for amyloid - Pathological review of all specimen by neuromuscular trained specialists **Recent Publications** - LepVax, a defined subunit vaccine that provides effective pre-exposure and post-exposure prophylaxis of M. leprae infection. Duthie MS, Pena MT, Ebenezer GJ, Gillis TP, Sharma R, Cunningham K, Polydefkis M, Maeda Y, Makino M, Truman RW, Reed SG. *NPJ Vaccines*. 2018 Mar 28;3:12. doi: 10.1038/s41541-018-0050-z. eCollection 2018. - Peripheral Neuropathy Induced by Microtubule-Targeted Chemotherapies: Insights into Acute Injury and Long-term Recovery. Wozniak KM, Vornov JJ, Wu Y, Liu Y, Carozzi VA, Rodriguez-Menendez V, Ballarini E, Alberti P, Pozzi E, Semperboni S, Cook BM, Littlefield BA, Nomoto K, Condon K, Eckley S, DesJardins C, Wilson L, Jordan MA, Feinstein SC, Cavaletti G, Polydefkis M, Slusher BS. *Cancer Res*. 2018 Feb 1;78(3):817-829. doi: 10.1158/0008-5472.CAN-17-1467. Epub 2017 Nov 30. - Chronic non-freezing cold injury results in neuropathic pain due to a sensory neuropathy. Vale TA, Symmonds M, Polydefkis M, Byrnes K, Rice ASC, Themistocleous AC, Bennett DLH. *Brain*. 2017 Oct 1;140(10):2557-2569. doi: 10.1093/brain/awx215. - Cutaneous nerve biomarkers in transthyretin familial amyloid polyneuropathy. Ebenezer GJ, Liu Y, Judge DP, Cunningham K, Truelove S, Carter ND, Sebastian B, Byrnes K, Polydefkis M. *Ann Neurol*. 2017 Jul;82(1):44-56. doi: 10.1002/ana.24972. Epub 2017 Jun 20. - An oral form of methylglyoxal-bis-guanylhydrazone reduces monocyte activation and traffic to the dorsal root ganglia in a primate model of HIV-peripheral neuropathy. Lakritz JR, Yalamanchili S, Polydefkis MJ, Miller AD, McGrath MS, Williams KC, Burdo TH. *J Neurovirol*. 2017 Aug;23(4):568-576. doi: 10.1007/s13365-017-0529-9. Epub 2017 May 1. - The Potential Role of Sensory Testing, Skin Biopsy, and Functional Brain Imaging as Biomarkers in Chronic Pain Clinical Trials: IMMPACT Considerations. Smith SM, Dworkin RH, Turk DC, Baron R, Polydefkis M, Tracey I, Borsook D, Edwards RR, Harris RE, Wager TD, Arendt-Nielsen L, Burke LB, Carr DB, Chappell A, Farrar JT, Freeman R, Gilron I, Goli V, Haeussler J, Jensen T, Katz NP, Kent J, Kopecky EA, Lee DA, Maixner W, Markman JD, McArthur JC, McDermott MP, Parvathenani L, Raja SN, Rappaport BA, Rice ASC, Rowbotham MC, Tobias JK, Wasan AD, Witter J. *J Pain*. 2017 Jul;18(7):757-777. doi: 10.1016/j.jpain.2017.02.429. Epub 2017 Feb 27. Review. - Sensory and autonomic function and structure in footpads of a diabetic mouse model. Liu Y, Sebastian B, Liu B, Zhang Y, Fissel JA, Pan B, Polydefkis M, Farah MH. *Sci Rep*. 2017 Jan 27;7:41401. doi: 10.1038/srep41401. - Assessing mNIS+7Ionis and international neurologists' proficiency in a familial amyloidotic polyneuropathy trial. Dyck PJ, Kincaid JC, Dyck PJB, Chaudhry V, Goyal NA, Alves C, Salhi H, Wiesman JF, Labeyrie C, Robinson-Papp J, Cardoso M, Laura M, Ruzhansky K, Cortese A, Brannagan TH 3rd, Khoury J, Khella S, Waddington-Cruz M, Ferreira J, Wang AK, Pinto MV, Ayache SS, Benson MD, Berk JL, Coelho T, Polydefkis M, Gorevic P, Adams DH, Plante-Bordeneuve V, Whelan C, Merlini G, Heitner S, Drachman BM, Conceição I, Klein CJ, Gertz MA, Ackermann EJ, Hughes SG, Mauermann ML, Bergemann R, Lodermeier KA, Davies JL, Carter RE, Litchy WJ. *Muscle Nerve*. 2017 Nov;56(5):901-911. doi: 10.1002/mus.25563. Epub 2017 Apr 7. - Peripheral neuropathic changes in pachyonychia congenita. Pan B, Byrnes K, Schwartz M, Hansen CD, Campbell CM, Krupiczojc M, Caterina MJ, Polydefkis M. *Pain*. 2016 Dec;157(12):2843-2853. - Epidermal innervation as a tool to study human axonal regeneration and disease progression. Khoshnoodi MA, Ebenezer GJ, Polydefkis M. *Exp Neurol*. 2017 Jan;287(Pt 3):358-364. doi: 10.1016/j.expneurol.2016.06.016. Epub 2016 Jun 15. Review. No abstract available. - Longitudinal Assessment of Small Fiber Neuropathy: Evidence of a Non-Length-Dependent Distal Axonopathy. Khoshnoodi MA, Truelove S, Burakgazi A, Hoke A, Mammen AL, Polydefkis M. *JAMA Neurol*. 2016 Jun 1;73(6):684-90. doi: 10.1001/jamaneurol.2016.0057.
Immunohistochemistry for analysis of intraepidermal nerve fiber density and sweat gland nerve fiber density of skin. Congo Red staining for amyloid analysis of skin. We are a CAP and CLIA certified laboratory and the first such laboratory to offer skin biopsy processing for intraepidermal nerve fibers.
Our laboratory has served as a core lab for over 2 dozen NIH-funded and industry clinical trials. We are expert at detailed immunohistochemistry and at identifying disease-relevant targets in the skin.
Protein Expression Visualization Services
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