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Small fiber neuropathy (SFN) is a disease of intraepidermal nerves fibers (IENF) (myelinated Aδ and unmyelinated C-fibers) prevalent in about 53/100,000 people. Mostly idiopathic, SFN can have various etiologies as alcoholism, diabetes, immune-mediated or infectious diseases. SFN commonly affects limbs in a distal to proximal gradient and manifests as various sensory symptoms. The diagnosis of SFN must fulfill following criteria : 1- a symptomatology consistent with neuropathic pains and autonomic complaints; 2- no central or motor involvement; 3- no nervous trunk achievement detected on electromyogram; 4- a reduction of IENF density (IENFD) in the distal area measured on skin biopsy ("gold standard" for diagnosis). This article is protected by copyright. All rights reserved.