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Journal of the American Academy of Dermatology
Volume 72, n° 2
pages 328-332 (février 2015)
Doi : 10.1016/j.jaad.2014.10.034
accepted : 24 October 2014
Original Articles

Pruritus: An underrecognized symptom of small-fiber neuropathies

Emilie Brenaut, MD a, d, , Pascale Marcorelles, MD, PhD c, d, e, Steeve Genestet, MD b, e, Dominique Ménard, MD e, f, Laurent Misery, MD, PhD a, d, e
a Department of Dermatology, University Hospital, Brest, France 
b Department of Clinical Neurophysiology, University Hospital, Brest, France 
c Department of Pathology, University Hospital, Brest, France 
d Laboratory of Neurosciences of Brest, University of Western Brittany, Brest, France 
e Breton Competence Center of Rare Neuromuscular Diseases and Neuropathies with Cutaneous-Mucosal Symptoms, Brest, France 
f Department of Neurology, University Hospital, Rennes, France 

Reprint requests: Emilie Brenaut, MD, Department of Dermatology, University Hospital, 2 avenue Foch, 29609 Brest, France.

Small-fiber neuropathies (SFN) are diseases of small nerve fibers that are characterized by autonomic and sensory symptoms.


We sought to evaluate sensory symptoms, especially pruritus, in patients with SFN.


A questionnaire was given to patients with SFN.


In all, 41 patients responded to the questionnaire (71.9% response rate). The most frequent sensory symptoms were burning (77.5%), pain (72.5%), heat sensations (70.2%), and numbness (67.5%). Pruritus was present in 68.3% of patients. It appeared most often in the evening, and was localized to the limbs in a distal-to-proximal gradient, although the back was the most frequent location (64%). Exacerbating factors were fatigue, xerosis, sweating, hot temperature, and stress. Cold water was an alleviating factor.


Recall bias associated with filling out the questionnaire, relatively small sample size, and the uncontrolled, retrospective nature of the study were limitations.


Pruritus occurs frequently in patients with SFN and could be recognized as a possible presenting symptom, especially if there are other sensory or autonomic symptoms.

The full text of this article is available in PDF format.

Key words : pruritus, questionnaire, sensory symptoms, small-fiber neuropathy

 Funding sources: None.
 Conflicts of interest: None declared.

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