I have idiopathic small fiber peripheral neuropathy and was diagnosed at Rochester Mayo Clinic. I did not have a skin punch biopsy but did have the nerve conduction tests and an EMG along with the neurological examination tests. The Foundation for Peripheral Neuropathy has an easy to understand list of the different tests - https://www.foundationforpn.org/tests/.

Bottom line for me is the skin punch biopsy would just be another test to confirm what I already know ( I have neuropathy) and would not change the treatments. Since I only have numbness and some tingling, there aren't any medications that help with the symptoms. Also, even though the biopsy is small, it's removing a tiny section of flesh along with the nerves (ones that are working and ones that are damaged/dead) that you will never get back - https://www.foundationforpn.org/tests/nerve-skin-muscle-tissue-biopsy/. I shared my neuropathy journey in another discussion along with other members here - https://connect.mayoclinic.org/comment/310341/.

I think it's great that you are learning more about your condition. That is what brought me to Connect back in 2016 and helped me learn from other members different ways to help myself.