Stimulated skin wrinkling for predicting intraepidermal nerve fibre density. 2009

Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
Division of Neurology, National University Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. mdcwse@nus.edu.sg

OBJECTIVE To determine the usefulness of stimulated skin wrinkling using EMLA and water immersion in detecting abnormal intraepidermal nerve fibre density. METHODS In a prospective study of patients with predominantly sensory polyneuropathy, we tested sensitivity and specificity of stimulated skin wrinkling using EMLA and water immersion in detecting abnormal intraepidermal nerve fibre density (IENFD). RESULTS EMLA stimulated wrinkling showed a sensitivity of 81.6% and specificity of 74.7% in detecting abnormal IENFD and water wrinkling a sensitivity of 71.4% and specificity of 73%. The positive and negative predictive values for detecting abnormal IENFD were 88.3% and 63.3% for EMLA wrinkling, for water wrinkling 83.3% and 57.4%. Intra-observer EMLA score variability was good with no change in assignment of wrinkling and inter-observer score variability resulted in 1-5 changes in wrinkling score which translated into a change of the wrinkling status from normal to abnormal on two occasions. CONCLUSIONS Stimulated skin wrinkling correlates well with abnormal intraepidermal nerve fibre density. CONCLUSIONS Our study suggests that EMLA induced stimulated skin wrinkling is a useful alternative parameter for predicting abnormal intraepidermal nerve fibre density.

UI MeSH Term Description Entries
D007101 Immersion The placing of a body or a part thereof into a liquid. Submersion,Immersions,Submersions
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011115 Polyneuropathies Diseases of multiple peripheral nerves simultaneously. Polyneuropathies usually are characterized by symmetrical, bilateral distal motor and sensory impairment with a graded increase in severity distally. The pathological processes affecting peripheral nerves include degeneration of the axon, myelin or both. The various forms of polyneuropathy are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance. Polyneuropathy, Acquired,Polyneuropathy, Critical Illness,Polyneuropathy, Familial,Polyneuropathy, Inherited,Polyneuropathy, Motor,Acquired Polyneuropathies,Acquired Polyneuropathy,Critical Illness Polyneuropathies,Critical Illness Polyneuropathy,Familial Polyneuropathies,Familial Polyneuropathy,Inherited Polyneuropathies,Inherited Polyneuropathy,Motor Polyneuropathies,Motor Polyneuropathy,Polyneuropathies, Acquired,Polyneuropathies, Critical Illness,Polyneuropathies, Familial,Polyneuropathies, Inherited,Polyneuropathies, Motor,Polyneuropathy
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011318 Prilocaine A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry. Propitocaine,Citanest,Citanest Octapressin,Prilocaine Hydrochloride,Xylonest
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011984 Sensory Receptor Cells Specialized afferent neurons capable of transducing sensory stimuli into NERVE IMPULSES to be transmitted to the CENTRAL NERVOUS SYSTEM. Sometimes sensory receptors for external stimuli are called exteroceptors; for internal stimuli are called interoceptors and proprioceptors. Nerve Endings, Sensory,Neurons, Sensory,Neuroreceptors,Receptors, Neural,Neural Receptors,Receptors, Sensory,Sensory Neurons,Sensory Receptors,Nerve Ending, Sensory,Neural Receptor,Neuron, Sensory,Neuroreceptor,Receptor Cell, Sensory,Receptor Cells, Sensory,Receptor, Neural,Receptor, Sensory,Sensory Nerve Ending,Sensory Nerve Endings,Sensory Neuron,Sensory Receptor,Sensory Receptor Cell
D005260 Female Females

Related Publications

Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
July 2008, Journal of neurology, neurosurgery, and psychiatry,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
April 2016, Histopathology,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
December 2011, Anticancer research,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
January 2019, Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
December 2019, Journal of clinical neuromuscular disease,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
February 2001, The Journal of dermatology,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
January 2020, Brain communications,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
November 2009, Diabetic medicine : a journal of the British Diabetic Association,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
June 2016, Journal of the neurological sciences,
Einar P Wilder-Smith, and Yaling Guo, and Adeline Chow
June 2014, Journal of the European Academy of Dermatology and Venereology : JEADV,
Copied contents to your clipboard!