Skin is an extremely complex and constantly remodeling organ that is not only a physical protective barrier but also an integration of the nervous, vascular, immune, and endocrine systems.


Given its complexity, over 150 diseases have been identified that affect the skin, its innervation, and blood supply. Many of these afflictions manifest with severe intractable numbness, chronic pain, and/or itch, which respond poorly to existing therapeutics.

Pathology investigations

Physical injury (trauma)

  • Complex regional pain syndrome (CRPS)
  • Carpal tunnel syndrome
  • Sciatica
  • Traumatic nerve injury
  • Post incisional pain
  • Frostbite

Systemic diseases

  • Therapeutic drug toxicity
  • Diabetic neuropathy and vasculopathy
  • Fibromyalgia
  • Chemotherapeutic neuropathy
  • Amyotrophic lateral sclerosis (ALS)
  • Drug addiction
  • Hypertension
  • Age-related neuropathy

Infections and autoimmune disorders

  • Post-herpetic neuralgia (PHN)
  • Osteoarthritis
  • Scleroderma
  • Raynaud’s disease
  • HIV neuropathy

Inherited diseases

  • Erythromelalgia
  • Congenital absence of pain
  • Neurofibromatosis



Skin biopsies provide an important diagnostic tool for impending or existing disease, and for developing therapeutics.


Normal subject

Subject with PHN

Increased TrpV1 on sensory endings (red arrows) and keratinocytes in the epidermis of humans with postherpetic neuralgia.

Petersen KL, Rice FL, Suess F, Berro M, Rowbotham MC (2002) Pain.

Normal subject

Subject with CRPS

Increased NaV1.6 on keratinocytes in the epidermis of humans with complex regional pain syndrome and postherpetic neuralgia.

Zhao P, Barr TP, Hou Q, Dib-Hajj SD, Black JA, Albrecht PJ, Petersen KL, Eisenberg E, Rice FL, Waxman SG (2008) Pain.

Normal subject

Subject with CRPS

Disrupted sensory endings on hair follicles are in humans with complex regional pain syndrome.

Albrecht PJ, Hines S, Eisenberg E, Pud D, Finlay DR, Connolly MK, Paré M, Davar G, Rice FL (2005) Pain.

Normal subject

Subject with type 2 diabetes

Selective loss of CGRP containing sensory endings on arteries as early as metabolic syndrome phase in aged monkeys with naturally occurring Type 2 diabetes.

Paré M, Albrecht PJ, Bodkin NL, Pittenger GL, Noto CJ, Schreyer DJ , Tigno XT, Hansen BC, Rice FL (2007) J Comp Neurol.

26-year-old control subject

24-year-old subject with fibromyalgia

Excessive sensory innervation on arteriole-venule shunts as seen in a 3 mm skin punch biopsy from the palm of the hand in a 24-year-old female fibromyalgia patient as compared to a 26-year-old female normal control.

Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL (2013). Pain Medicine.

Multiple benefits of skin biopsy

Existing research, much of it conducted by the cofounders of INTiDYN, has shown that microscopic immunochemical assessments of skin sections from 3 mm punch biopsies are an invaluable means for:

  1. Elucidating the nature and potential basis of skin and nerve pathologies.
  2. Assessing the efficacy of therapeutics and providing insights for potential future therapeutic strategies.
  3. Diagnosing existing and impending disease, such as diabetes, before the overt manifestation of the disease, thereby providing the potential for appropriate intervention before a more intractable problem occurs.
  4. Detecting potential detrimental side effects associated with drug development for other diseases such as arthritis and hypertension. This is due to the fact that the skin is a constantly remodeling structure that integrates multiple systems.
  5. Evaluating the specificity of novel reagents, such as antibodies, that are designed to detect the location of specific functional molecules.


Conducting research and collaborating with our extensive network of scientists and medical professionals to further understand function of the skin and related systems, as well as nerve, skin, and pain disorders, is a top priority.

View a selection of our published research