Ichthyosiform Sarcoidosis-Reply

In Reply.—  The diagnosis of sarcoidosis in our patient was made on the basis of chest roentgenographic studies, a positive Kveim test, negative intradermal skin tests (PPD and Candida albicans), and skin biopsy findings.In answer to your inquiry, the patient was born and raised in Philadelphia. She never traveled outside the northeastern United States. Examination of the coin-shaped lesions and the ichthyotic skin failed to show any impairment in sensory function, and there was no thickening or enlargement of peripheral nerves.Multiple biopsy specimens from the coin-shaped lesions as well as the ichthyotic areas showed only noncaseating granulomas without any infiltration of cutaneous appendages or nerves. Furthermore, an acid-fast stain, Fite, was performed on all biopsy materials; no organism was found, as stated in the report. Special stains for nerve were not attempted because of lack of nerve involvement.When one considers the patient's background, roentgenographic findings, the positive