A Clinical and Histopathologic Study of Rubella / 대한피부과학회지

ABSTRACT

BACKGROUND: Although rubella is a mild exanthematous viral infection and its incidence has been greatly decreased after effective vaccination, epidemics of rubella has been noted at 5- to 7-year intervals. But there has been few report about the clinical and histopathologic study of rubella in Korean literatures. OBJECTIVE: The purpose of this study was to review the clinical and histopathologic characteristics of rubella of 1996 outbreak. METHODS: We reviewed the clinical features and histopathologic findings in 50 patients diagnosed as rubella in Department of Dermatology, Presbyterian Medical Center from January 1996 through to May 1996. RESULTS: 1. The male-female ratio was 1 .17. The age distribution was 13-32 years and 72% of patients were aged 16-25 years. 2. Erythematous maculopapular rash on whole body was developed in all patients. Eighty two percent of the patients had fever and lymphadenopathy, and 36% of the patients had petechiae of soft palate. The main prodromal symptoms were sore throat(50%), headache(34%), and upper respiratory symptoms(22%), as order of frequency. 3. Positive serologic test for rubella IgM antibody was 79.5%. 4. The most common abnormal laboratory finding was leukopenia(58%), and followed by positive ASO(34%), the presence of atypical lymphocytes(21%), and thrombocytopenia(8%). 5. Histologically, epidermal changes were mild to moderate vacuolopathy(92.3%), the presence of dyskeratotic cells(30.8%), spongiosis(23.1%), and exocytosis(15.4%). Dermal findings were mild superficial perivascular lymphohistiocytic infiltration(100%), upper dermal edema(53.8%), perivascular edema(38.4%), pigmentary incontinence(30.8%), and the presence of extravasated RBC(23.1%). Eosinophil infiltration(15.4%) and the presence of large nucleated lymphocytes(92.3%) were also observed. Conclusions: According to the results of our study about rubella outbreak in 1996, clinical signs and symptoms were similar to those of previously described. Histologically, superficial perivascular dermatitis with mild to mederate vacuolar interface change was a main feature and large nucleated lymphocytes were frequently noted.