Recently, punch skin biopsy studies in type II diabetes indicated that skin microcirculation may be involved in the pathogenesis of painful DPN; in fact, Shillo et al. (2021) demonstrated a significant increase in MVB in subjects with DDPN, particularly in the painful DDPN group using dermal von Willebrand factor (vWF) as a BV marker. The gene discussed is VWF; the disease is type 2 diabetes mellitus.