Loss of Cutaneous Sensory Nerve Terminals

  Dear CCF Doctors:
  I was wondering if anyone in the US is doing studies on Cutaneous Sensory Neuropathies.  My Neuroligist feels my skin symptoms (itch, pain, rawness,hyper pores like when one is cold, burning pain, sensitivity to temperatures, little raised bumps ) are all related to the Cutaneous Sensory Neuropathy I have. I had previously been to several Dermatologist who diagnosed skin conditions, but the reality is the skin (epidermis or dermis) is reacting to the inflammation from the nerve damage or decrease in the density of epidermal neurites that creates what looks like skin conidtions.
  I have seen on this forum where skin reactions are often disregarded as part of a neuropathic picture.  But, it seems cutaneous sensory neuropathies do cause these strange symptoms.
     Aside from pain medications are there things being used one can apply to the skin that aids this problem.  Or aids in healing of these cutaneous nerve fibers?  Are there any known things used to aid in the regeneration of these cutaneous nerve fibers?  It appears not too many Neurologists know much about this condition.  I was wondering if it is because this is a new field of study or if the physicians in my area are not aware of the correlation between skin phenomena related specifically to cutaneous sensory neuropathies.  Any information you can provide, or sources of information would be most appreciated. As always Thanks for this wonderful forum.
===========================================================================
Dear Ellen:
Skin changes (swelling, circulatory stasis, coldness, loss of sweating, increased sensitivity, redness, trophic changes from loss of sensation) are common features of peripheral neuropathy with a prominent small-fiber component (superficial sensation, autonomic function). Some specific causes of neuropathy may have very specific skin abnormalities associated with them - for instance, leprosy, amyloidosis, toxic neuropathies, osteosclerotic myeloma, cryoglobinemia, vasculitis, and even diabetes.
To my knowledge, however, there is no new specific "cutaneous sensory neuropathy" described. I suspect that your neurologist may simply be referring to skin manifestations of a sensory neuropathy. Also, I think it is quite unusual that a peripheral neuropathy should be confused with a skin problem.
I the last few years special processing of skin biopsy is being developed as a very sensitive test for small fiber neuropathy. Such work is being conducted in only a few academic institutions in the US, the Cleveland Clinic being one of them.
There is no approved treatment available yet that can make nerves regenerate. While growth factors are being researched, I do not think they will be available in the near future. And certainly, they will not be locally applies to the skin.
I hope this answers your question.