--so at least you have to show it to the doctor; many do not know about all those serological tests for potential PN causes. And, of course, having that article to show is no guarantee that a physician will order all, or any of those tests, but it's better to go in forearmed. (Many of us here can tell stories of clueless, empathy-challenged physicians and of having to go to many doctors to finally get one interested in doing a full work-up.)

The skin biopsy is very simple--a few shots of xylocaine or other local anesthetic, a small "punch" of skin removed (usually about 3mm in diameter and 1mm thick), and a band-aid. It is so simple almost any physician can do it--it is the preparation and analysis which is complex and only done at advanced medical centers, as it requires electron microscopy and trained enumerators.

Generally, samples are taken from the lower leg just above the ankle, from the outside of the thigh several inches below the hip bone, and sometimes from the upper arm skin just above the elbow--these are the areas that have had the most "norming" done for comparison purposes. Generally these are done all on one side, but both sides can be done if an asymmetrical neuropathy is suspected. (In fact, a biopsy can be taken from any place there is hairy skin--but samples from a lot of other areas have not been 'normed' to any great extent in research and it would be difficult to tell what abnormal density would be.)