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For diagnostic procedure of small-fiber pathology, 47 studies were totally considered.<\/jats:p><jats:p>Recent diagnostic criteria should be applied (ACR, 2016). A rheumatologic visit seems mandatory. The involvement of small fibers should request at least 2 among HRV\u2009+\u2009SSR and\/or laser-evoked responses and\/or skin biopsy and\/or corneal confocal microscopy, eventually followed by monitoring of metabolic and\/or immunological\/ and or\/paraneoplastic basis, to be repeated at 1-year follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The correct diagnostic approach to FM could promote the exclusion of the known causes of small-fiber impairment. 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