Debi
Debi, mine is in my mouth, tongue, arms, hands, legs, feet, back, ears, everywhere. Just starting this journey for a diagnosis.

I also had only one biopsy, above the right ankle. This was what my neurologist asked for, and I knew nothing about SFN and this test.

Actually I am glad that I had only one biopsy, this was more then enough for me. I had a massive bleeding, I was sensitive to the antibiotic ointment, it took a long time to heal, and for a couple of months the pain disturned my sleep and activities that streach the area such as walking, going down the stairs, or yoga. Sometimes the area is still annoying and it has been almost a year since my biopsy.

Did you actually have the biopsy called "sural"? This one is deep and cuts the sural nerve, and provides axonal samples.

The skin biopsy is very shallow and should not bleed or cause lingering problems. The sural however, is quite brutal and can cause problems that last for years.

I had the skin biopsy.

I didn't know whether I was sensitive to the local anesthesia so the doctor did the biopsy without the anesthesia, and without requesting my consent to do it this way!!
I guess that's why he might have done it quickly and carelessly.
On the results it was written that the sample diameter was 4mm and 8mm length. Isn't it too deep?
A few minutes after I got out of the clinic I had to return because the blood went out of the thick bandage..
Later at home I also developed sensitivity/allergy to the antibiotic ointment.
When my neuro saw the scar about 2-3 months later he said it shouldn't look like that and referred me to a dermatologist.

Sorry to hear you've had issues post biopsy. Mine wasn't as bad, but it didn't fully heal for a month, and became quite infected. I used antibiotic ointment, which didn't work, and then alcohol and peroxide, which finally did the trick. But I can say that my wounds have been healing very slowly and poorly for some time now, likely due to immunity issues. I've noticed this for a while now, certainly ever since the SFN started.

One of my most consistent symptoms is neuropathic itch, and itching in general, and early on I recall scratching a place, say the top of foot or my hand, and then the skin would break open very easily, then the next day it would get infected. It was almost as if I has something trying to get out, some fungus or bacteria, and perhaps it was precisely that.

I am sorry you have such diffuculties with wound healing and itching.
I didn't have any infection with the biopsy, it felt as if the pain was caused by somewhere deeper.
I have allways had sensitive skin, atopic dermatitis, rashes that comes and goes, and many sensitivities, but it is much different than what you described.

Thank you for your kind words. I see now that our situations are different. I do get rashes now and then, and my skin problems are there, but they're not that systemic and extreme.

--4mm by 8mm incision is NOT standard for a skin biopsy, which is generally a 3mm diameter, 1mm thick sample.

Given the location, it sounds more like they did the more invasive sural nerve biopsy to me.

Mine was 3x1 too. 4x8 seems quite different, indicating inexperience or an entirely different biopsy.

It does sounds as if you may have had an actual nerve biopsy as opposed to a skin biopsy, which is not really invasive. That said, I'm no expert but I did have a skin biopsy. Perhaps you can go back to your doctor to double check what they did...either way I'm sorry to hear you have damage from the test.

Cliffman