Title: DISTRIBUTION OF RUBELLA VIRUS IN THE SKIN DURING ACUTE RUBELLA WITH AND WITHOUT RASH
Abstract: In a previous study to assess the role of rubella virus in the pathogenesis of the rubella exanthem, virus was isolated from cell cultures of skin biopsy specimens of the rash in 13 of 14 patients with this disease. It was postulated, therefore, that although other factors might be involved, the presence of virus in the skin was essential to evolution of the rash. To further investigate the association of virus with rash, punch biopsies were performed concurrently on areas of skin with and without rash. Cell cultures were prepared from the skin specimens and the resulting cell monolayers were tested for rubella virus. From paired skin specimens from 16 patients, virus was isolated from sites of rash in 12, and from the uninvolved skin in 10. In another patient who was shown by serologic response and recovery of virus from the pharynx to have rubella without a rash, virus was also isolated from the skin. These data indicate that in acute rubella the virus is generally distributed throughout the skin irrespective of the presence or distribution of the rash. It is concluded, therefore, that although the presence of virus in the skin appears to be a constant feature of the disease, it is only one of the factors essential to evolution of the rubella exanthem.