248 Sensitive Skin can be Small Fiber Neuropathy: Results from a Case-control Quantitative Sensory Testing Study

Abstract

Sensitive skin syndrome (SSS) is defined as the occurrence of unpleasant sensations (itch, pain, burnings, prickling…) in response to stimuli that should not normally cause such sensations. Previous studies show that SSS could be a small-fiber neuropathy but quantitative sensory testing (QST) is lacking. Using QST, the aim of the study was to determine the presence or absence of tactile sensitivity disorder, mainly heat-pain threshold (HPT 0.5), in subjects with SSS. Neuropathic pain was assessed by two questionnaires: the DN4 and the Neuropathic Pain Symptom Inventory (NPSI). This monocentric case-control study included 21 subjects with SSS and 21 controls. The subjects underwent quantitative sensory testing. Neuropathic pain was assessed by two questionnaires: the DN4 and the Neuropathic Pain Symptom Inventory (NPSI). Forty-two subjects were included in the study. The HPT 0.5 was significantly lower in the cases (14.5+/-2.8) than in the controls (17.8+/-2.5) (p<0.001). Intermediate pain (HPT 5.0) was also significantly decreased in SSS. The DN4 and NPSI scores were significantly higher in the cases compared to the controls. The decrease in HPT in subjects with SSS compared to controls suggests the presence of hyperalgesia, probably due to the damage of C-fibers. These findings, as well as the increased DN4 and NPSI scores, strengthen the neuronal hypothesis of SSS and are new arguments for consideration of SSS as small fiber neuropathy.