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Case Reports
. 2023 Nov-Dec;40(6):1107-1111.
doi: 10.1111/pde.15337. Epub 2023 May 18.

Rubella virus-associated necrotizing granulomatous inflammation with extensive eyelid, ocular, and orbital involvement

Matthew A Pimentel  1 , Donna H Kim  2 , Lorne W Walker  3 , Michelle B Noelck  4 , Ludmila Perelygina  5 , Kimberly A Kripps  6 , Victoria W Cartwright  7 , Tracy Funk  1 , Sarah Green  8 , Annie Kuo  2 , John Ng  2 , Solveig L Ophaug  1 , Ross Passo  2 , Travis Redd  2 , Alison Small  1
Affiliations
Case Reports

Rubella virus-associated necrotizing granulomatous inflammation with extensive eyelid, ocular, and orbital involvement

Matthew A Pimentel et al. Pediatr Dermatol. 2023 Nov-Dec.

Abstract

We present a case of cutaneous granulomatous disease associated with rubella virus in a 4-year-old girl without an identifiable immunodeficiency. In this case, a combination of anti-inflammatory, anti-viral, and anti-neutrophil therapies successfully treated vision-threatening eyelid, conjunctival, scleral, and orbital inflammation.

Keywords: granuloma; rubella; vaccine.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Alison Small is a consultant and investigator for Palvella Therapeutics. Tracy Funk is a consultant and investigator for Palvella Therapeutics and an investigator for Abbvie Inc and Arcutis Biotherapeutics.

Figures

FIGURE 1
FIGURE 1
A partial excisional biopsy of the right lower eyelid showed suppurative and granulomatous inflammation.
FIGURE 2
FIGURE 2
Immunohistochemistry stains showing rubella viral capsid (red) in CD206 expressing (green) M2 macrophages and nuclei (blue) with the overlay.
FIGURE 3
FIGURE 3
Immunohistochemistry stains showing rubella viral capsid (red) in myeloperoxidase expressing (green) neutrophils and nuclei (blue) with the overlay.
FIGURE 4
FIGURE 4
Progression of granulomatous disease to involve right inferior conjunctiva and new necrotic nodule of the left superior medial eyelid.
FIGURE 5
FIGURE 5
Two months post hospitalization after treatment with systemic medications and serial eye exams under anesthesia.
See this image and copyright information in PMC

References

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