Track

Clinical Studies

Abstract

Rubella Virus (RuV) was declared eradicated from the United States in 2004, however multiple cases of RuV have been identified within biopsies of cutaneous granulomatous disease in recent years. RuV cutaneous granulomatous disease (RuV-GD) has been most described in immunosuppressed patients; however, it has also been reported in immunocompetent adults. RuV-GD is a novel condition with no current histopathologic consensus among dermatopathologists. The objective of this study is to establish a consensus on the histopathologic patterns for cases of RuV-GD to help guide dermatopathologists in diagnosis. We conducted an observational study to collect responses from dermatopathologists participating in a consensus of the histopathological features of RuV -GD in 32 patients. All cases were sent to the Centers for Disease Control and Prevention (CDC) for rubella immunohistochemical staining. Participating dermatopathologists were asked to evaluate the pathology slides of these 32 patient cases, which included nineteen positive RuV-CD cases and eleven cases that found to be RuV negative. Participants reviewed the slides in person or through a virtual dermatopathology slide viewer. Information obtained through the consensus process included the classification of the primary granulomatous pattern (sarcoidal, tuberculoid, palisading, and interstitial), the presence or absence of fibrosis, necrosis, eosinophils, lymphocytes and plasma cells. Using this data, we hope to clarify and define the histopathological characteristics which will serve as a tool for further research on the pathogenesis of RuV-GD and will guide next steps to advancing medical knowledge on this novel condition.