Skin tests in sarcoidosis

Abstract

Skin sensitivity in sarcoidosis has been investigated using tuberculin and Candida albicans antigen. Sixty-nine per cent of 102 cases of sarcoidosis gave a negative Mantoux reaction to 100 TU PPD compared with 20 per cent of controls. Among sarcoidosis patients who failed to react to tuberculin alone, tuberculin-cortisone gave reactions in 50 per cent indicating in these the presence of tuberculin sensitivity of a degree too slight to be elicited by tuberculin alone. Sixty per cent of sarcoidosis patients gave no reaction to a Candida albicans antigen, compared with 10 per cent of controls. Eighty-four per cent of control subjects reacted both to tuberculin and Candida albicans antigen compared with only 7 per cent of patients with sarcoidosis. The literature on skin tests in sarcoidosis is reviewed and the place of skin tests in the diagnosis of sarcoidosis is discussed. Possible causes of the abnormal skin responses are considered. Evidence is presented to suggest that at least in some cases there is a causal relationship between sarcoidosis and tuberculosis.