Background: Patients with cutaneous manifestations associated with peripheral neuropathy often present to the dermatologist's office. Objective/Methods: This article outlines a practical approach for obtaining the history, performing a screening physical examination, and ordering initial diagnostic testing to diagnose the cause of nondiabetic neuropathy. When to refer for neurologic consultation and principles of management of neuropathic pain and neuropathy-related ulcers are also discussed. Results: Cutaneous manifestations of peripheral neuropathy may be secondary to a medical condition predisposing the patient to neuropathy or a manifestation of neuropathy itself. In the latter category, skin affected by neuropathy may show characteristics of xerosis, anhidrosis, rubor, edema, callus, ulceration, muscle wasting, and foot deformity. Most often these findings occur in association with diabetic neuropathy; however, many other infectious, inflammatory, metabolic, paraneoplastic, hereditary, and medication- or toxin-related causes should be considered. The treatment of cutaneous manifestations of neuropathy includes pressure downloading, control of edema, and optimal ulcer and neuropathic pain management. Conclusion: It is important for dermatologists to have a basic approach to neuropathy in patients with related skin disease. Referral to Neurology is warranted when basic workup for reversible causes is negative or for any severe, rapidly progressive symptoms. Contexte: Les manifestations cutanees associees a la neuropathie peripherique donnent souvent lieu a des consultations en dermatologie. Objectif/Methode: Le present article expose une demarche pratique d'obtention de l'anamnese, de realisation de l'examen physique de depistage, et de prescription d'examens diagnostiques de base permettant de cerner la cause de la neuropathie non diabetique. Il sera egalement question de la pertinence des consultations en neurologie ainsi que des principes de prise en charge de la douleur neuropathique et des ulceres lies a la neuropathie. Resultats: Les manifestations cutanees de la neuropathie peripherique peuvent etre secondaires a un etat sous-jacent, favorable a la neuropathie ou a une manifestation de la neuropathie elle-meme. Entrent dans cette derniere categorie des manifestations cutanees telles que le xerosis, l'anhidrose, la rougeur, l'OEdeme, les durillons, les ulceres, l'amyotrophie, et les deformations du pied. La plupart du temps, ces manifestations sont liees a la neuropathie diabetique; cependant, bon nombre d'autres causes possibles: infectieuses, inflammatoires, metaboliques, paraneoplasiques, hereditaires, medicamenteuses, ou toxiques, devraient etre envisagees. Le traitement des manifestations cutanees de la neuropathie comprend la diminution de la pression, la reduction de l'OEdeme, et la prise en charge optimale des ulceres et de la douleur neuropathique. Conclusions: Il est important que les dermatologues aient une approche de base a l'egard de la neuropathie chez les patients en presentant des manifestations cutanees. Les consultations en neurologie sont justifiees dans les cas d'absence de cause reversible d'apres le bilan de base ou d'evolution rapide et grave des symptomes.
