The exanthem of Ross River virus infection: histology, location of virus antigen and nature of inflammatory infiltrate.

The exanthem of epidemic polyarthritis, a disease caused by Ross River (RR) virus, was examined three days after onset of the common erythematous and the rare purpuric forms of the eruption. The dermis showed a light perivascular infiltrate of mononuclear cells in both, with extravasation of erythrocytes in the latter. No immunoglobulins (IgM, IgG, IgA) or complement components (Clq, C3) were detected. Most of the infiltrating cells were T lymphocytes of the T suppressor-cytotoxic class. Their perivascular location, the scarcity of other lymphocytes or phagocytes, and rapid resolution of the rash indicated that the T lymphocytes were responsible for cytotoxic destruction of virus-infected cells. A few monocyte-macrophage cells were identified in the perivascular infiltrate. RR virus antigen was found in the basal epidermal and eccrine duct epithelial cells of both types of lesion and in the perivascular zone of the erythematous lesion, but appeared to have been eliminated from this region in the purpuric lesion. It is suggested that secondary effects of the T-cytotoxic reaction on nearby capillaries are responsible for erythema, oedema and purpura in the exanthem.