A review of the literature reveals that most investigators look upon the Kveim test (KVT) as a valuable aid in the diagnosis of sarcoidosis. Numerous histological specimens available to our laboratory, studied extensively by Nelson and coworkers,8,9,10 stimulated us to review most of them in an attempt to classify the histologic changes that take place in the skin after the performance of a KVT. It is also our purpose to define more clearly the histological picture required to interpret a KVT as positive or negative.
Boeck believed that the presence of the granuloma itself necessitated a histological diagnosis of sarcoidosis. Later, however, others disagreed.1,2,11,17 The classical investigations of Lewandowsky and Kyrle4,6 indicated that the granuloma in sarcoidosis is not characteristic at the beginning, and may lose its typical structure in the late stages. In addition, it was found that several other conditions may resemble sarcoidosis histologically.13,15
STEIGLEDER GK, SILVA A, NELSON CT. Histopathology of the Kveim Test. Arch Dermatol. 1961;84(5):828–834. doi:10.1001/archderm.1961.01580170122017