Figure 7.

Staining for PGP9.5 in control skin, NPDPN Q +SOC and PDPN Q+SOC before and after application of Capsaicin 8% patch Qutenza (Q) treatment (50 μm sections). (A) Control skin biopsy section, from a healthy human volunteer (intra–epidermal nerve fibers marked with arrowheads and sub–epidermal nerve fibers with arrows). (B) Skin biopsy section from a subject with NPDPN Q+SOC pre–treatment (Q PRE); few intra–epidermal nerve fibers and sub–epidermal nerve fibers were observed before treatment. (C) Skin biopsy section from same subject with painless DPN (NPDPN Q+SOC) as above post–treatment (Q POST): the abundance of both the IENFs and SENFs appeared restored. (Scale bar 50 μm, Original magnification x40). (D) Skin biopsy section from a subject with PDPN Q+SOC pre–treatment (Q PRE); Few intra–epidermal nerve fibers and with abnormal trajectory before capsaicin application (arrowheads). (E–G) Examples from biopsies collected 3. 6 and 9 months (Q POST 1, 2, 3) after a single Qutenza application respectively. Note the restored abundance of both IENF and SENF, and the vertical trajectory of IENF Q POST, as observed in control skin. (Scale bar 100 μm, original magnification x20).