Should Skin Biopsies Be Performed in Patients Suspected of Having Parkinson’s Disease?

Figure 1

Obtaining a skin biopsy containing a sweat gland and staining of sudomotor nerve fibers. A punch biopsy is obtained and stained using immunohistochemical antibodies for α-synuclein (e.g., anti-phosphorylated α-synuclein antibody) and nerve fibers (anti-protein gene product 9.5 antibody). Additional costaining with the cholinergic marker vasoactive intestinal peptide can be performed to specifically identify α-synuclein deposits in cholinergic sudomotor fibers. Figure designed by Dr. Siepmann and Dr. Illigens.