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To the Editor.—
We recently saw a patient with the unusual clinical manifestation of generalized cutaneous sarcoidosis with clinical evidence of histoplasmosis involving the right eye.The patient was a 14-year-old boy, who had lived in North Carolina all his life. When he was 11 years old, he was first noted to have erythema, atrophy, and dilated blood vessels in the skin on his lower extremities. Shortly thereafter, he developed violaceous plaques on his chest and right axilla. A biopsy specimen from one of the plaques showed a granulomatous reaction compatible with sarcoidosis. Stains for fungi and acid-fast organisms were negative. There was no organomegaly or lymphadenopathy at that time, and all laboratory data obtained were within normal limits. The patient was placed on a regimen of 30 mg of prednisone every other day; the skin lesions improved thereafter.When the patient was 13 years old, a Kveim test was