{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:50:12Z","timestamp":1791366612734,"version":"4.3.1"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cutaneous wrinkling is a normal phenomenon that occurs on the palms in a reversible manner and results from vasoconstriction influenced by vasomotor function. It can be assessed through the skin-wrinkling test following water immersion, with the absence or reduction of wrinkling being associated with disorders affecting the dense network of sympathetic nerves in these regions. The literature suggests that this test may serve as a screening tool for small-fiber neuropathy, particularly in settings in which biopsy is not available. It is a rapid, inexpensive, and easily-accessible test. We herein review the principles of the skin-wrinkling test, its pathophysiology, and its clinical indications as a tool to evaluate the sympathetic component of the autonomic nervous system.<\/jats:p>","DOI":"10.1055\/s-0046-1827046","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T23:16:11Z","timestamp":1786662971000},"page":"001-007","source":"Crossref","is-referenced-by-count":0,"title":["The skin-wrinkling test: principles and clinical applications"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0778-5376","authenticated-orcid":false,"given":"Otto Jesus Hern\u00e1ndez","family":"Fustes","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Complexo do Hospital de Cl\u00ednicas, Curitiba PR, Brazil."},{"name":"Universidade Federal do Paran\u00e1, Curitiba PR, Brazil."},{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0173-0809","authenticated-orcid":false,"given":"Cl\u00e1udia Suemi Kamoi","family":"Kay","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Complexo do Hospital de Cl\u00ednicas, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4457-7771","authenticated-orcid":false,"given":"Paulo Jos\u00e9","family":"Lorenzoni","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Complexo do Hospital de Cl\u00ednicas, Curitiba PR, Brazil."},{"name":"Universidade Federal do Paran\u00e1, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1673-5074","authenticated-orcid":false,"given":"Renata Dal-Pr\u00e1","family":"Ducci","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Complexo do Hospital de Cl\u00ednicas, Curitiba PR, Brazil."},{"name":"Universidade Federal do Paran\u00e1, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8024-0009","authenticated-orcid":false,"given":"Paula Raquel do Vale Pascoal","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Complexo do Hospital de Cl\u00ednicas, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-0831","authenticated-orcid":false,"given":"Orlando Graziani Povoas","family":"Barsottini","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3957-5317","authenticated-orcid":false,"given":"Rosana Herminia","family":"Scola","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Curitiba PR, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1002\/1097-4598(200007)23:7<1105::AID-MUS14>3.0.CO;2-A","article-title":"Skin and muscle vasomotor reflexes in detecting autonomic dysfunction in leprosy","volume":"23","author":"E P Wilder-Smith","year":"2000","journal-title":"Muscle Nerve"},{"issue":"02","key":"ref2","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s10286-004-0172-4","article-title":"Water immersion wrinkling\u2013physiology and use as an indicator of sympathetic function","volume":"14","author":"E P Wilder-Smith","year":"2004","journal-title":"Clin Auton 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