Skin sympathetic adrenergic innervation: An immunofluorescence confocal study

Objective: The aim of this study was to characterize sympathetic adrenergic innervation of the skin in healthy subjects using dopamine beta hydroxylase (DOH) as a specific marker for noradrenergic fibers. Methods. Sympathetic adrenergic innervation of human skin was studied in 10 healthy subjects by indirect immunofluorescence and confocal microscopy applied to punch skin biopsies. Noradrenergic fibers were identified both in glabrous and hairy skin using D beta H antibody. Results: D beta H immunoreactive fibers were mainly localized in arteriovenous anastomoses, arrector pilorum muscles, and arterioles, whereas few adrenergic fibers were found around sweat glands. Interpretation: Our description of sympathetic adrenergic innervation of human skin aims to improve the diagnostic ability of skin biopsy to detect selective autonomic nervous system disorders.