Hi Bowtie,

I have small nerve fiber polyneuropathy, confirmed by skin biopsy on my right leg. Left leg is now affected as well. Pain in my hands, especially the palms, appeared after my leg symptoms. My Neurologist explained that it typically presents in feet first and then progresses up from there to legs and hands. That is why the skin biopsy is taken from the leg. But she said typically......There are exceptions to this I am sure, where hands/arms come first. Sorry, my experience may not be helpful to you.
Would love to hear back from you if you learn an answer to your specific question! Thanks!