{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:50:17Z","timestamp":1789915817004,"version":"4.0.1"},"reference-count":50,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,26]],"date-time":"2021-12-26T00:00:00Z","timestamp":1640476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Government of the Russian Federation","award":["075-15-2021 dated September 29, 2021"],"award-info":[{"award-number":["075-15-2021 dated September 29, 2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathophysiology"],"abstract":"<jats:p>Chronic pain may affect 30\u201350% of the world\u2019s population and an important cause is small fiber neuropathy (SFN). Recent research suggests that autoimmune diseases may be one of the most common causes of small nerve fiber damage. There is low awareness of SFN among patients and clinicians and it is difficult to diagnose as routine electrophysiological methods only detect large fiber abnormalities, and specialized small fiber tests, like skin biopsy and quantitative sensory testing, are not routinely available. Corneal confocal microscopy (CCM) is a rapid, non-invasive, reproducible method for quantifying small nerve fiber degeneration and regeneration, and could be an important tool for diagnosing SFN. This review considers the advantages and disadvantages of CCM and highlights the evolution of this technique from a research tool to a diagnostic test for small fiber damage, which can be a valuable contribution to the study and management of autoimmune disease.<\/jats:p>","DOI":"10.3390\/pathophysiology29010001","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T01:06:54Z","timestamp":1640567214000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Corneal Confocal Microscopy in the Diagnosis of Small Fiber Neuropathy: Faster, Easier, and More Efficient Than Skin Biopsy?"],"prefix":"10.3390","volume":"29","author":[{"given":"Mariia V.","family":"Lukashenko","sequence":"first","affiliation":[{"name":"Laboratory Mosaic Autoimmunity, St. Petersburg State University, 199304 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Y.","family":"Gavrilova","sequence":"additional","affiliation":[{"name":"Laboratory Mosaic Autoimmunity, St. Petersburg State University, 199304 St. Petersburg, Russia"},{"name":"Department of Phthisiopulmonology, St. Petersburg Scientific Research Institute of Phthisiopulmonology, 199304 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1679-4565","authenticated-orcid":false,"given":"Anna V.","family":"Bregovskaya","sequence":"additional","affiliation":[{"name":"Department of endocrinology, Almazov National Medical Research Centre, 199304 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-0418","authenticated-orcid":false,"given":"Lidiia A.","family":"Soprun","sequence":"additional","affiliation":[{"name":"Laboratory Mosaic Autoimmunity, St. Petersburg State University, 199304 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6359-0026","authenticated-orcid":false,"given":"Leonid P.","family":"Churilov","sequence":"additional","affiliation":[{"name":"Laboratory Mosaic Autoimmunity, St. Petersburg State University, 199304 St. Petersburg, Russia"},{"name":"Department of Phthisiopulmonology, St. Petersburg Scientific Research Institute of Phthisiopulmonology, 199304 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis N.","family":"Petropoulos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha 24144, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha 24144, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehuda","family":"Shoenfeld","sequence":"additional","affiliation":[{"name":"Laboratory Mosaic Autoimmunity, St. Petersburg State University, 199304 St. Petersburg, Russia"},{"name":"Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel HaShomer 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69997801, Israel"},{"name":"President, Ariel University, Ariel 4077625, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/jns.12128","article-title":"Improving assessment in small fiber neuropathy","volume":"20","author":"Brouwer","year":"2015","journal-title":"J. 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