ESC is intended to provide insight into and assess sudomotor (or sweat gland) function and small fiber peripheral neuropathy.
The measure was principally developed by Impeto Medical to diagnose cystic fibrosis from historical research at the Mayo Clinic and then tested on others diseases with peripheral neuropathic alterations in general.
During normal physiological function, activation of eccrine sweat glands starts with a “chemical” stimulus.
A comprehensive technology review, including the mathematical model underlying the concept along with its theoretical assumptions, can be found in the summary paper From Sudoscan to Bedside: Theory, Modalities, and Applications of Electrochemical Skin Conductance in Medical Diagnostics.
[11] The apparatus consists of stainless-steel electrodes for the hands and the feet which are connected to a computer for recording and data management purposes.
Sweat glands are most numerous on the palms of the hands and soles of the feet, and thus well suited for sudomotor function evaluation.
Advanced or painful DSPN may result not only in reduced quality of life, but has been statistically associated with retinopathy and nephropathy, and leads to considerable morbidity and mortality.
[37][38] Because early symptoms of CAN tend to be nonspecific, its diagnosis is frequently delayed and screening for CAN should be routinely considered in diabetic patients.
[39][40][41][42] In that context being able to detect earlier the diabetic neuropathies and skin dryness with electrochemical conductance to avoid complication has been proposed for DFU management.
[50][51] Chemotherapy-induced peripheral neuropathy is a common, potentially severe and dose-limiting adverse effect of multiple chemotherapeutic agents.
CIPN can persist long after the completion of chemotherapy and imposes a significant quality of life and economic burden to cancer survivors.
Small fiber neuropathy is common and may arise from a number of conditions such as diabetes, metabolic syndrome, infectious diseases, toxins, and autoimmune disorders.
The gold standard for diagnosing small fiber neuropathy as the etiology of neuropathic pain is skin biopsy.
Sudomotor assessment, an accurate objective technique, could be considered as a good screening tool to limit skin biopsy in patients in whom it is not suitable.