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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Dec 20, 2025; 15(4): 111043
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.111043
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.111043
Molecular insights from skin biopsies: Deciphering microvascular pathology in peripheral vascular diseases
Maneesha Kumari, Department of Medicine, Peoples University of Medical and Health Sciences, Nawabshah 67480, Sindh, Pakistan
Narainder Kumar, Rahol Meghwar, Rahul Rai, Kapeel Kumar, Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Sindh, Pakistan
FNU Rahul, Department of Medicine, Chandka Medical College, Larkana 77170, Sindh, Pakistan
Muhammad Ali Hassan, Department of Medicine, Avicenna Medical College, Lahore 53100, Punjab, Pakistan
Hanesh Kumar, Department of Medicine, Hubei University of Arts and Sciences Medical College, Xiangyang 441053, Hubei Province, China
Muhammad Hashir Naveed Chaudhary, Department of ENT, East Cheshire NHS Trust, Macclesfield SK10 3BL, Cheshire East, United Kingdom
Kainaat Zahid, Farah Alam, Department of Medicine, DOW Medical College, Karachi 74200, Sindh, Pakistan
Inshal Jawed, Umair Qadir, Department of Medicine, Dow University of Health Sciences, Karachi 75300, Sindh, Pakistan
Danaish Kumar, Shafaq Jabeen, Department of Medicine, Karachi Medical and Dental College, Karachi 74700, Sindh, Pakistan
Rabia Asim, Department of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi 78200, Sindh, Pakistan
Author contributions: Kumari M and Kumar N conceived and designed the study; Kumar M, Kumar N, and Meghwar R drafted the initial manuscript; Kumar N, Meghwar R, Rai R, and Rahul F performed the initial study screening and selection; Kumar N, Meghwar R, Rai R and Jabeen S conducted the comprehensive literature search and database queries; Meghwar R, Hassan MA, and Kumar K conducted the data extraction and quality assessment using the Cochrane risk of bias tool and Newcastle-Ottawa Scale; Rai R, Kumar K, Kumar H and Zahid K performed the data synthesis and analysis; Rai R, Hassan MA, Kumar K, Chaudhary MHN and Jawed I critically reviewed and revised the manuscript for important intellectual content; Alam F, Kumar D, Qadir U and Asim R revised the manuscript; all authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The authors declare no conflicts of interest or financial interests related to the content of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Inshal Jawed, Chief Physician, Senior Researcher, Department of Medicine, Dow University of Health Sciences, Baba-E-Urdu Road, Karachi 75300, Sindh, Pakistan. inshaljwd@gmail.com
Received: June 23, 2025
Revised: July 23, 2025
Accepted: October 29, 2025
Published online: December 20, 2025
Processing time: 181 Days and 2 Hours
Revised: July 23, 2025
Accepted: October 29, 2025
Published online: December 20, 2025
Processing time: 181 Days and 2 Hours
Core Tip
Core Tip: The systematic review highlights the crucial role of skin biopsies in the diagnosis of peripheral vascular diseases, particularly in terms of histopathological and molecular investigations. The study of skin biopsies is highly informative in understanding diseases in terms of microvascular pathology, endothelial dysfunction, and inflammation, such as systemic sclerosis, diabetic vasculopathy, and vasculitis. The incorporation of molecular markers, such as vascular endothelial growth factor, intercellular adhesion molecule-1, and endothelial nitric oxide synthase, highlights the potential of skin biopsies in enhancing diagnostic accuracy and stratifying patients. Nonetheless, some difficulties related to the standardization of both biopsy and molecular testing remain, which necessitate additional studies to apply it in practice.