apparatus . improvements to test articular cartilage : recent

They found that biopsy specimens from the patients with sarcoidosis showed lymphoid infiltrates consistent with class I (1+) or less on Tarpley's classification, and that all patients with class II (2+) or higher had SS. As we have not found any other studies on a similar scale that test the discriminatory efficacy of lip biopsy for these two diseases we believe that present evidence favours the hypothesis that our patient had both sarcoidosis and SS. Although Melsom and colleagues did not employ Tarpley's classification, their description is compatible with at least class II (2+). Hence probably both diseases were also present in their case. A statistically significant association between SS and sarcoidosis is yet to be proved; nevertheless, it would not be surprising if we bear in mind that both diseases are characterised by an intense cellular immune response, predominantly composed of T lymphocytes, at sites of disease.7 8 Sarcoidosis could therefore become a new member in the list of immunological disorders associated with 'secondary' SS. Several clinically relevant considerations could be inferred from this association. The presence of adenopathies in a patient with a diagnosis of SS, as occurred in Melsom's case as well as ours, suggests the possibility not only of an associated lymphoma but also of coexistent sarcoidosis. On the other hand, lip biopsy in patients with sarcoidosis may not only be useful as confirmatory evidence of sarcoid involvement, but also for eliminating concomitant SS.